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General NPI Number Information
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NPI Number | 1689063000
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Entity Type | Individual
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Provider Name | SHANNON MCNABB LCPC
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Gender | Female
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Dates
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Enumeration Date | 01/22/2015
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 900 N ORANGE ST STE 304
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City | MISSOULA
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State | MT
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Zip | 59802-2951
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Country | US
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Telephone | 406-327-3362
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Fax | 406-327-3349
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Provider Business Mailing Address
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Address Line | PO BOX 12
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-0012
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Country | US
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Telephone | 509-824-1284
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 74821
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License Number State | TX
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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 | BBH-LCPC-LIC-8346
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | SWP-LCPC-LIC-8346
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License Number State | MT
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