Shannon Amber Wilson, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801091814 Issued in MI

Practice address

215 E Green St
Marshall, MI 49068-1534

Phone

(269) 248-1624

NPI assigned

Sep 15, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: shannon.wilson.1@9698.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1013225754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 1/2 W MICHIGAN AVE STE B",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490681556",
            "telephone_number": "269-753-4826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E GREEN ST",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490681534",
            "telephone_number": "269-248-1624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHANNON",
        "middle_name": "AMBER",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015191",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC12620",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Wilke, PA-C
• Sheryl Wilkinson, LMSW
• Ginger Williams, MD
• Erin Wilson
• Jolene Wilson, RDH
• Shelly Wisz
• Pamela Y Wolfersberger, CRNA
• Rebecca Dawn Womble, FNP-C
• Melissa S Wooden, P.A.
• Woodhaven Counseling LLC

• Clinical Social Worker in Marshall, MI
• Providers in Marshall, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.