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NPI Code Detail

MEDICARE: SHANNON BLACK DOTSON LPC

MEDICARE: SHANNON BLACK DOTSON LPC
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
1101YM0800XMental Health CounselorC.2203928-TRNEOH
2101YM0800XMental Health CounselorE.2606219OH
3101YM0800XMental Health CounselorC.2205152OH

General Provider Information

NPI Number : 1285376715
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON BLACK DOTSON LPC
Provider Business Mailing Address
First Line : 100 DORCHESTER SQ N STE 102
Second Line :
City : WESTERVILLE
State : OH
Zip : 43081-7305
Country : US
Telephone Number : 614-890-8262
Fax Number :
Provider Business Practice Location Address
First Line : 100 DORCHESTER SQ N STE 102
Second Line :
City : WESTERVILLE
State : OH
Zip : 43081-7305
Country : US
Telephone Number : 614-890-8262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2022
Last Update Date : 02/23/2026

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Directions to “ SHANNON BLACK DOTSON LPC” Practice Location

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