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General NPI Number Information
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NPI Number | 1083971634
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Entity Type | Individual
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Provider Name | SHANNA LEARN LPC
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Gender | Female
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Dates
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Enumeration Date | 04/20/2012
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Last Update Date | 04/20/2012
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Provider Practice Location Address
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Address Line | 2409 CENTRAL AVE APT. 208
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City | WILDWOOD
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State | NJ
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Zip | 08260-5232
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Country | US
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Telephone | 814-504-3514
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2646
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City | WILDWOOD
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State | NJ
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Zip | 08260-8646
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Country | US
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Telephone | 814-504-3514
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 37PC00448800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00448800
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 37PC00448800
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License Number State | NJ
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