Shannon, Lucinda Susan
Shannon, Lucinda Susan is an individual health care provider with primary practice located at 2201 Ironwood Place , Coeur D Alene ID 83814. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Shannon, Lucinda Susan can be contacted via phone (208) 769-4222.Contact Information
Primary practice address
2201 Ironwood Place
Coeur D Alene ID 83814
Phone: (208) 769-4222
Fax: (844) 803-7399
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LCSW889 | Idaho |
Profile Details
| NPI number | 1962495259 |
|---|---|
| LBN Legal business name | Shannon, Lucinda Susan |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 23rd, 2005 |
| Last updated | Aug 3rd, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962495259 | NPPES |
| Idaho | MEDICAID | 800012721 | |
| Idaho | Other | HPS21 |
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