MEDICARE: SHANNON K MEANEY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	090259	NY
2	1041C0700X	Clinical Social Worker	090259	NY
3	101YM0800X	Mental Health Counselor	090259	NY

General Provider Information

NPI Number	:	1851223515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON K MEANEY LCSW

Provider Business Mailing Address
First Line	:	PO BOX 665
Second Line	:
City	:	CROSS RIVER
State	:	NY
Zip	:	10518-0665
Country	:	US
Telephone Number	:	914-623-3026
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 665
Second Line	:
City	:	CROSS RIVER
State	:	NY
Zip	:	10518-0665
Country	:	US
Telephone Number	:	914-623-3026
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

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Directions to “ SHANNON K MEANEY LCSW” Practice Location

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