Provider Demographics
NPI:1124535349
Name:WILLSUN, DEANIN SAVON (LPCC)
Entity type:Individual
Prefix:MRS
First Name:DEANIN
Middle Name:SAVON
Last Name:WILLSUN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1317 MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-4712
Mailing Address - Country:US
Mailing Address - Phone:612-568-2357
Mailing Address - Fax:
Practice Address - Street 1:1317 MEADOW CT
Practice Address - Street 2:
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-4712
Practice Address - Country:US
Practice Address - Phone:612-568-2357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC03827101YM0800X
MN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health