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NPI Code Detail

MEDICARE: SHANNA LOTT LSW

MEDICARE: SHANNA LOTT LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker33011874AIN

General Provider Information

NPI Number : 1124838933
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNA LOTT LSW
Provider Business Mailing Address
First Line : 1130 WILDWOOD DR
Second Line :
City : KOKOMO
State : IN
Zip : 46901-1816
Country : US
Telephone Number : 765-271-6560
Fax Number : 317-469-1674
Provider Business Practice Location Address
First Line : 1234 N COURTLAND AVE
Second Line :
City : KOKOMO
State : IN
Zip : 46901-2754
Country : US
Telephone Number : 765-860-8365
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2025
Last Update Date : 01/13/2025

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Directions to “ SHANNA LOTT LSW” Practice Location

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