LESLIE K SHAN (NPI# 1578018172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578018172 |
| Entity Type | Individual |
| Full Name | LESLIE K SHAN |
| Other Name | LESLIE K ALLARD |
| Credential | MS |
| Practice Address |
11020 State Route 250 Lawrenceville IL 62439 |
| Mailing Address |
11020 State Route 250 Po Box 516 Lawrenceville IL 62439 |
| Practice Telephone | 6189433754 |
| Practice Fax Number | 6189433657 |
| Mailing Telephone | 6189433754 |
| Mailing Fax Number | 6189433657 |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2016-08-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 376003178 (008) | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629289343 | Leslie Shan | Optometrist | 22550 Town Cir, Moreno Valley, CA 92553-7502 | 2007-05-24 |
| Street Address |
11020 STATE ROUTE 250 |
| City | LAWRENCEVILLE |
| State | IL |
| Zip Code | 62439 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770515728 | Kimothy Ann Fulk | Nurse Practitioner | 11020 State Route 250, Lawrenceville, IL 62439-3379 | 2006-07-07 |
| 1417511619 | Jodi Stone | Counselor | 11020 State Route 250, Lawrenceville, IL 62439-3379 | 2019-04-24 |
| 1396200531 | Andrew F. Caldwell | Counselor | 11020 State Route 250, Lawrenceville, IL 62439 | 2019-02-01 |
| 1679065742 | Marissa Beth Hake | Registered Nurse | 11020 State Route 250, Lawrenceville, IL 62439-3379 | 2018-06-04 |
| 1649773946 | Angela Parish | Nurse Practitioner | 11020 State Route 250, Lawrenceville, IL 62439-3379 | 2018-03-13 |
| 1144739194 | Logan Kermicle | Counselor | 11020 State Route 250, Lawrenceville, IL 62439 | 2017-09-21 |
| 1982055687 | David Patrick Penk | Counselor | 11020 State Route 250, Lawrenceville, IL 62439 | 2016-06-24 |
| 1366824559 | Emily Michele Brown | Counselor | 11020 State Route 250, Lawrenceville, IL 62439 | 2015-06-24 |
| 1205233822 | Jenna Gonzalez | Counselor | 11020 State Route 250, Lawrenceville, IL 62439-3379 | 2014-11-25 |
| 1497151641 | Sarah Fehrenbacher | Counselor | 11020 State Route 250, Lawrenceville, IL 62439-3379 | 2014-11-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801406590 | Allyson Fiscus | Nurse Practitioner | 11020 Il-250, Lawrenceville, IL 62439 | 2020-08-06 |
| 1164071700 | Lauren E Welton | Case Manager/Care Coordinator | 11362 Country Club Road, Lawrenceville, IL 62439 | 2019-09-06 |
| 1962063354 | Connie Deckard | Counselor | Lawrence County Health Department Behavior Health, 11020 State Route 250, Lawrenceville, IL 62439 | 2019-06-26 |
| 1225485527 | Megan Joergens | Social Worker | 11120 State Route 250, Lawrenceville, IL 62439 | 2016-05-17 |
| 1235509456 | Christy M Wimberly | Private Vehicle | 1417 Dubios St., Lawrenceville, IL 62439 | 2015-09-30 |
| 1144637521 | Joy Singson Uy | Physical Therapist | 2101 James St United Methodist Village North, Lawrenceville, IL 62439 | 2014-07-17 |
| 1760791792 | Lawrence Co | Secured Medical Transport (VAN) | 2009 Lexington Ave, Lawrenceville, IL 62439 | 2010-09-24 |
| 1134358922 | Lawrence County Health Department | Public Health or Welfare | Rural Route3 Box 430, Lawrenceville, IL 62439 | 2009-07-14 |
| 1366678161 | Judith Joan Phipps | Counselor | Rr1 Box 277, Lawrenceville, IL 62439 | 2009-06-08 |
| 1366648784 | S. Hurn Baek | Radiology | Lawrence County Memorial Hospital, Radiology, 2200 W. State St., Lawrenceville, IL 62439 | 2007-06-22 |
| Find all providers in zip 62439 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134735202 | Lighthouse Family Service Center | Counselor | 150 Stanley Ct Ste B, Lawrenceville, GA 30046-5215 | 2020-09-23 |
| 1285248005 | Laura Meeks | Counselor | 1929 Whitehawk Ct, Lawrenceville, GA 30043-6641 | 2020-08-31 |
| 1184237125 | Luz Melania Soto Garcia | Counselor | 760 Longleaf Blvd Ste A, Lawrenceville, GA 30046-8458 | 2020-08-28 |
| 1962063354 | Connie Deckard | Counselor | Lawrence County Health Department Behavior Health, 11020 State Route 250, Lawrenceville, IL 62439 | 2019-06-26 |
| 1366001695 | Holton Ariel Daniel | Counselor | 233 N Main St Ste B, Lawrenceville, VA 23868-1807 | 2019-06-11 |
| 1326603119 | Easter's Family Services | Counselor | 102 E Hicks St Ste 303, Lawrenceville, VA 23868-1830 | 2019-05-07 |
| 1023577053 | Brittany Williams | Counselor | 175 Gwinnet Drive, Lawrenceville, GA 30046-8444 | 2019-03-19 |
| 1699230052 | Josephine Lola Banjoko | Counselor | 1402 Park Hollow Ln, Lawrenceville, GA 30043-3878 | 2019-02-09 |
| 1285104315 | Shalanda Monique Booker | Counselor | 2940 Emerald Springs Drive, Lawrenceville, GA 30045 | 2018-12-02 |
| 1902376551 | Lekicha Monique Cabiness | Counselor | 102 Hicks St. Suite 303, Lawrenceville, VA 23868 | 2018-11-27 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 62439 |
Please comment or provide details below to improve the information on LESLIE K SHAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.