Provider Demographics
NPI:1083420988
Name:SCIBOR, SHANNON E (LPC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:E
Last Name:SCIBOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2517 HIGHWAY 35 STE D201
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1982
Mailing Address - Country:US
Mailing Address - Phone:732-231-5170
Mailing Address - Fax:
Practice Address - Street 1:337 DRUM POINT RD STE 2B
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6885
Practice Address - Country:US
Practice Address - Phone:732-231-5170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00952000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional