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NPI Code Detail

MEDICARE: MS. ANN PATRICIA SHANNON LCSW

MEDICARE: MS. ANN PATRICIA SHANNON LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCSW003738GA

General Provider Information

NPI Number : 1134240757
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANN PATRICIA SHANNON LCSW
Provider Business Mailing Address
First Line : 363 RESOURCE PKWY
Second Line :
City : WINDER
State : GA
Zip : 30680-8364
Country : US
Telephone Number : 770-597-1647
Fax Number :
Provider Business Practice Location Address
First Line : 2578 HELEN HWY
Second Line :
City : CLEVELAND
State : GA
Zip : 30528-2848
Country : US
Telephone Number : 770-219-9100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2007
Last Update Date : 01/03/2025

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