Healthcare Provider Details

I. General information

NPI: 1710108055
Provider Name (Legal Business Name): SHANNON ROBINSON LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18501 DENHIGH CIR
OLNEY MD
20832-1882
US

IV. Provider business mailing address

18501 DENHIGH CIR
OLNEY MD
20832-1882
US

V. Phone/Fax

Practice location:
  • Phone: 240-863-2048
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11867
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: