Healthcare Provider Details

I. General information

NPI: 1689593022
Provider Name (Legal Business Name): SHANNON MAJOR LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 FAIRBANKS DRIVE
VALDEZ AK
99686
US

IV. Provider business mailing address

PO BOX 1192
VALDEZ AK
99686-1192
US

V. Phone/Fax

Practice location:
  • Phone: 907-835-9355
  • Fax:
Mailing address:
  • Phone: 907-202-4391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number136545
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number136545
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: