Active NPI
Shannon Elaine Queiroga, MA, LPC
- Professional Counselor
- Norwalk, CT
National Provider Identifier
1124211628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 002477
- Practice address
- 137 East Ave
2ND Floor
Norwalk, CT 06851-5702 - Phone
- (203) 415-5321
- NPI assigned
- Aug 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 002477 | CT | Primary |
Addresses
Primary practice location
137 East Ave
2ND Floor
Norwalk, CT 06851-5702
Mailing address
47 Monroe St
Apt. D
Milford, CT 06460-5725
Phone (203) 415-5321
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002477 | CT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407110400000",
"number": "1124211628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47 MONROE ST",
"address_2": "APT. D",
"city": "MILFORD",
"state": "CT",
"postal_code": "064605725",
"telephone_number": "203-415-5321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "137 EAST AVE",
"address_2": "2ND FLOOR",
"city": "NORWALK",
"state": "CT",
"postal_code": "068515702",
"telephone_number": "203-415-5321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUEIROGA",
"first_name": "SHANNON",
"middle_name": "ELAINE",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-20",
"last_updated": "2014-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "002477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwalk, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.