Basic Information
| Provider Information | |||||||||
| NPI: | 1083278113 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WINTON | ||||||||
| FirstName: | SHAWN | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8202 CICERO TRL | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374211305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4235805846 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1200 DODSON AVE | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374063214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237782800 | ||||||||
| FaxNumber: | 4237782869 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2019 | ||||||||
| LastUpdateDate: | 04/24/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 3983 | TN | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.