Provider Demographics
NPI:1457608473
Name:PUNTENEY, SHAWNNA (LPC, NCC)
Entity type:Individual
Prefix:
First Name:SHAWNNA
Middle Name:
Last Name:PUNTENEY
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 THELMA DR # 222
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-2325
Mailing Address - Country:US
Mailing Address - Phone:307-262-5810
Mailing Address - Fax:
Practice Address - Street 1:301 THELMA DR
Practice Address - Street 2:#222
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-2325
Practice Address - Country:US
Practice Address - Phone:307-262-5810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC829101YP2500X
WYLPC 829101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor