Healthcare Provider Details

I. General information

NPI: 1841130788
Provider Name (Legal Business Name): SHANNON MARIA BARBERO BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 DEAN ST
BECKLEY WV
25801-2103
US

IV. Provider business mailing address

103 DEAN ST
BECKLEY WV
25801-2103
US

V. Phone/Fax

Practice location:
  • Phone: 304-890-9934
  • Fax:
Mailing address:
  • Phone: 304-890-9934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: