Healthcare Provider Details

I. General information

NPI: 1679483002
Provider Name (Legal Business Name): SHANNON MARGARET MCCABE CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 DOUGLAS PIKE STE 200
SMITHFIELD RI
02917-1879
US

IV. Provider business mailing address

900 DOUGLAS PIKE STE 200
SMITHFIELD RI
02917-1879
US

V. Phone/Fax

Practice location:
  • Phone: 401-228-2186
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP02083
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: