Healthcare Provider Details

I. General information

NPI: 1124116843
Provider Name (Legal Business Name): SHANNON L HILFER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 E CENTRAL AVE
BISMARCK ND
58501-2066
US

IV. Provider business mailing address

1303 E CENTRAL AVE
BISMARCK ND
58501-2066
US

V. Phone/Fax

Practice location:
  • Phone: 701-323-5626
  • Fax: 701-255-4495
Mailing address:
  • Phone: 701-323-5626
  • Fax: 701-255-4495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number442-4-1-00-159
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number442-4-1-00-159
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: