Individual provider · Type 1 NPI

Shane Church, LMHC

Mental Health Counselor · Orlando, FL

NPI number 1194265405 Active

Practice location

4776 New Broad St Ste 201
Orlando, FL 32814-6423

Fax (407) 219-9624

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XMH24135 (FL)

Mental Health Counselor: Definition to come...

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About NPI 1194265405

Shane Church, LMHC's National Provider Identifier is 1194265405, issued on Mar 6, 2017. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Orlando, FL. The record was last updated on Aug 6, 2025.