Healthcare Provider Details

I. General information

NPI: 1548588312
Provider Name (Legal Business Name): SHAWN YANTIS LPC-MHSP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 DOWELL SPRINGS BLVD STE 330
KNOXVILLE TN
37909-2445
US

IV. Provider business mailing address

3606 W ANDREW JOHNSON HWY
MORRISTOWN TN
37814-3603
US

V. Phone/Fax

Practice location:
  • Phone: 865-371-8573
  • Fax:
Mailing address:
  • Phone: 865-378-6929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7601
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: