Healthcare Provider Details

I. General information

NPI: 1497670996
Provider Name (Legal Business Name): ERIN OCONNELL SHANNON LLMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 W BIG BEAVER RD STE &80
TROY MI
48084-4736
US

IV. Provider business mailing address

888 W BIG BEAVER RD STE 780
TROY MI
48084-4745
US

V. Phone/Fax

Practice location:
  • Phone: 248-406-6756
  • Fax:
Mailing address:
  • Phone: 984-289-6747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851122281
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: