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NPI Code Detail

MEDICARE: MRS. SHANNON RENEE LIEBURN LPC

MEDICARE: MRS. SHANNON RENEE LIEBURN LPC
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 CounselorLPC04417KS

General Provider Information

NPI Number : 1982544680
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHANNON RENEE LIEBURN LPC
Provider Business Mailing Address
First Line : 11515 S BLACKBOB RD
Second Line :
City : OLATHE
State : KS
Zip : 66062-4901
Country : US
Telephone Number : 913-489-7336
Fax Number :
Provider Business Practice Location Address
First Line : 11515 S BLACKBOB RD
Second Line :
City : OLATHE
State : KS
Zip : 66062-4901
Country : US
Telephone Number : 913-489-7336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2026
Last Update Date : 03/31/2026

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