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General NPI Number Information
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NPI Number | 1710943287
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Entity Type | Individual
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Provider Name | STEPHANIE SHANK M.S., LMHC
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Gender | Female
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 969 KEYSTONE WAY STE 100
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City | CARMEL
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State | IN
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Zip | 46032-3001
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Country | US
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Telephone | 317-440-4176
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Fax | 775-288-3479
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Provider Business Mailing Address
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Address Line | 969 KEYSTONE WAY STE 100
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City | CARMEL
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State | IN
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Zip | 46032-3001
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Country | US
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Telephone | 317-440-4176
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Fax | 775-288-3479
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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 | 39001720A
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License Number State | IN
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