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General NPI Number Information
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NPI Number | 1992044465
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Entity Type | Individual
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Provider Name | SHANNON FAY MATHIS MEYER LCSW, CACII
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Gender | Female
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 3478 MARTHA BERRY HWY NE
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City | ROME
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State | GA
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Zip | 30165-7713
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Country | US
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Telephone | 404-477-4888
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Fax |
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Provider Business Mailing Address
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Address Line | 8735 DUNWOODY PL STE R
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City | ATLANTA
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State | GA
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Zip | 30350-2995
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW005915
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License Number State | GA
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