Individual provider · Type 1 NPI
Shannon Theobald, LPC
Professional Counselor · Parsippany, NJ
NPI number
1669146205
Active
Practice location
181 New Rd Ste 304
Parsippany, NJ 07054-5625
Mailing address
151 Lake Ave
Boonton, NJ 07005-1135
Other practice locations
- 155 Lake Ave, Boonton, NJ 07005-1135 · (201) 407-7047
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 37PC00896500 (NJ) |
Professional Counselor: Definition to come...
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About NPI 1669146205
Shannon Theobald, LPC's National Provider Identifier is 1669146205, issued on Aug 6, 2021. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Parsippany, NJ. The record was last updated on Oct 18, 2022.