Provider Demographics
NPI:1447123013
Name:GREANIAS, SHANNON LYNN
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:LYNN
Last Name:GREANIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 ASH AVE
Mailing Address - Street 2:
Mailing Address - City:PEWEE VALLEY
Mailing Address - State:KY
Mailing Address - Zip Code:40056-9146
Mailing Address - Country:US
Mailing Address - Phone:502-241-8454
Mailing Address - Fax:
Practice Address - Street 1:2401 ASH AVE
Practice Address - Street 2:
Practice Address - City:PEWEE VALLEY
Practice Address - State:KY
Practice Address - Zip Code:40056-9146
Practice Address - Country:US
Practice Address - Phone:502-241-8454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY275868103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling