Provider Demographics
NPI:1063223253
Name:WHITT, SHANNON LYNN (LMFT)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:LYNN
Last Name:WHITT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5207 IDAHO AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-3306
Mailing Address - Country:US
Mailing Address - Phone:917-553-4371
Mailing Address - Fax:
Practice Address - Street 1:210 25TH AVE N STE 601
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1631
Practice Address - Country:US
Practice Address - Phone:917-553-4371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1928106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist