MEDICARE: MR. SHAWN WHITEHORN SR. MS, LPC, NCC

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
1	101YP2500X	Professional Counselor	178006993	IL

General Provider Information

NPI Number	:	1144521295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHAWN WHITEHORN SR. MS, LPC, NCC

Provider Business Mailing Address
First Line	:	1800 BOX RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31907-3222
Country	:	US
Telephone Number	:	706-545-4902
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 BOX RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31907-3222
Country	:	US
Telephone Number	:	706-545-4902
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2010
Last Update Date	:	08/14/2013

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