Individual provider · Type 1 NPI

Shannon Logan, LAC

Mental Health Counselor · Lyndhurst, NJ

NPI number 1508424060 Active

Practice location

1050 Wall St W Ste 310
Lyndhurst, NJ 07071-3615

Call (732) 982-2888 Map

Fax (847) 859-5885

Mailing address

175 E Hawthorn Pkwy Ste 235
Vernon Hills, IL 60061-1454

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X37AC00293400 (NJ)

Mental Health Counselor: Definition to come...

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About NPI 1508424060

Shannon Logan, LAC's National Provider Identifier is 1508424060, issued on May 30, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lyndhurst, NJ. The record was last updated on May 30, 2019.