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NPI Code Detail

MEDICARE: SHANNON S. CARMONA LPC

MEDICARE:   SHANNON S. CARMONA  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
1101YP2500XProfessional CounselorLPC-11175AZ

General Provider Information

NPI Number : 1790015170
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON S. CARMONA LPC
Provider Business Mailing Address
First Line : 4139 E WADING POND DR
Second Line :
City : TUCSON
State : AZ
Zip : 85712-6629
Country : US
Telephone Number : 520-571-0034
Fax Number :
Provider Business Practice Location Address
First Line : 2225 E AJO WAY
Second Line :
City : TUCSON
State : AZ
Zip : 85713-6201
Country : US
Telephone Number : 520-740-5044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2010
Last Update Date : 01/06/2010

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Directions to “ SHANNON S. CARMONA LPC” Practice Location

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