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NPI Code Detail

MEDICARE: MRS. SHANNON MAUREEN GONTER LPCC

MEDICARE: MRS. SHANNON MAUREEN GONTER LPCC
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
1101YM0800XMental Health Counselor245776KY

General Provider Information

NPI Number : 1568842227
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHANNON MAUREEN GONTER LPCC
Provider Business Mailing Address
First Line : 1949 GOLDSMITH LN STE 103
Second Line :
City : LOUISVILLE
State : KY
Zip : 40218-3096
Country : US
Telephone Number : 502-413-2137
Fax Number :
Provider Business Practice Location Address
First Line : 1949 GOLDSMITH LN STE 103
Second Line :
City : LOUISVILLE
State : KY
Zip : 40218-3096
Country : US
Telephone Number : 502-413-2137
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2015
Last Update Date : 01/10/2024

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Directions to “ MRS. SHANNON MAUREEN GONTER LPCC” Practice Location

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