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General NPI Number Information
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NPI Number | 1740650746
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Entity Type | Individual
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Provider Name | ROBIN DANA SHANNON LCPC
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Gender | Female
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Dates
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Enumeration Date | 10/02/2015
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 3336 W LAWRENCE AVE STE 202
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City | CHICAGO
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State | IL
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Zip | 60625-6543
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Country | US
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Telephone | 773-676-9204
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Fax |
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Provider Business Mailing Address
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Address Line | 4610 N CLARK ST # 1057
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City | CHICAGO
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State | IL
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Zip | 60640-4620
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Country | US
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Telephone | 773-676-9204
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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 | 180.013639
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License Number State | IL
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