Provider Demographics
NPI:1407193766
Name:ANDREA, SHANNON (LPCC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:ANDREA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:617 OAK ST
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-3610
Mailing Address - Country:US
Mailing Address - Phone:218-829-7140
Mailing Address - Fax:218-829-7142
Practice Address - Street 1:209 S 2ND ST STE 300
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-3639
Practice Address - Country:US
Practice Address - Phone:888-833-2859
Practice Address - Fax:218-818-6726
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00535101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional