Shannon Klosak, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT93637 Issued in CA

Practice address

324 E Bixby Rd
Long Beach, CA 90807-3432

Phone

(562) 595-8111

Fax

(562) 595-8148

NPI assigned

Jun 20, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Shannon Klosak Professional name

Medicare fee-for-service enrollment

Enrolled in CA, TX, CO, AZ4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 4

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• CO HMO
• NM HMO C-SNP
• CO HMO D-SNP
• devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
• TX HMO
• TX HMO D-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Marriage & Family Therapist

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  AZ, CO, Marriage & Family Therapist, TX

  Medicare reassignment NPD
• SKT Therapy Inc

  • Marriage & Family Therapist
  • Corona, CA
  • NPI 1629559802
  NPD Authorized official

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1013356229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 E BIXBY RD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073432",
            "telephone_number": "562-595-8111",
            "fax_number": "562-595-8148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E BIXBY RD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073432",
            "telephone_number": "562-595-8111",
            "fax_number": "562-595-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOSAK",
        "first_name": "SHANNON",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT93637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "KLOSAK",
            "credential": "CATC-IV",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Isabella Klausing
• Kristy Kleiman
• Kristen Marie Klein
• Samuel John Kleist
• Sheila Klick
• Ryan Klotz
• Nataliya Vadimovna Kloyzner, FNP-BC
• Adam Klueger, DPT
• KMK Clinical Inc
• Steven John Kniffen, SUDRC LL, CMPSS

• Marriage & Family Therapist in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.