MEDICARE: SHANNON MARTIN COUNSELING, PLLC

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1659232429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHANNON MARTIN COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	288 WEST ST STE 3B
Second Line	:
City	:	MILFORD
State	:	MA
Zip	:	01757-1234
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	288 WEST ST STE 3B
Second Line	:
City	:	MILFORD
State	:	MA
Zip	:	01757-1234
Country	:	US
Telephone Number	:	508-978-3081
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHANNON MARTIN
Credential	:	LMHC
Telephone Number	:	508-978-3081

Provider Enumeration Date	:	11/20/2025
Last Update Date	:	11/20/2025

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