Provider Demographics
NPI:1861789109
Name:MORRISON, SHAWNA LYNN (MS)
Entity type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:LYNN
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:SHAWNA
Other - Middle Name:LYNN
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:2014 VANDALIA ST
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234-4848
Mailing Address - Country:US
Mailing Address - Phone:618-345-9536
Mailing Address - Fax:
Practice Address - Street 1:2014 VANDALIA ST
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-4848
Practice Address - Country:US
Practice Address - Phone:618-345-9536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000143106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist