MEDICARE: SHAWN YANTIS LPC-MHSP

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	7601	TN

General Provider Information

NPI Number	:	1548588312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWN YANTIS LPC-MHSP

Provider Business Mailing Address
First Line	:	3606 W ANDREW JOHNSON HWY
Second Line	:
City	:	MORRISTOWN
State	:	TN
Zip	:	37814-3603
Country	:	US
Telephone Number	:	865-378-6929
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 DOWELL SPRINGS BLVD STE 330
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37909-2445
Country	:	US
Telephone Number	:	865-371-8573
Fax Number	:

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

Provider Enumeration Date	:	05/04/2010
Last Update Date	:	04/02/2025

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