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NPI Code Detail

MEDICARE: SHYANNE MARIE ANTHONY LPC

MEDICARE: SHYANNE MARIE ANTHONY 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 Counselor2021040968MO
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1992472443
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHYANNE MARIE ANTHONY LPC
Provider Business Mailing Address
First Line : 21143 LAYLA RD
Second Line :
City : WAYNESVILLE
State : MO
Zip : 65583-3130
Country : US
Telephone Number : 417-533-2571
Fax Number :
Provider Business Practice Location Address
First Line : 13160 COUNTY ROAD 3610
Second Line :
City : SAINT JAMES
State : MO
Zip : 65559-9151
Country : US
Telephone Number : 573-261-3251
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2021
Last Update Date : 01/31/2024

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