=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295219889
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHANNON GARDNER ADAMS LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2018
-----------------------------------------------------
Last Update Date | 04/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 237 W JAMISON CT
-----------------------------------------------------
City | LITTLETON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80120-4206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-597-9749
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2808 MAYFIELD RD APT 406
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44118-5207
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-597-9749
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | CSW.09929755
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------