Shannon Alford
Individual provider Active NPI Mental Health Counselor · Indianapolis, IN
NPI 1134767692 · NPPES record last updated Dec 16, 2019
Key facts
- NPI
- 1134767692
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 39003421A (IN)
- Practice address
- 6130 Michigan Rd
Indianapolis, IN 46228-1200 - Phone
- (317) 925-2833
- NPI assigned
- Dec 16, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240821001258 | IN | Practitioner - Mental Health Counselor | 4385182393 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Damien Center Inc | Mental Health | Current |
Accepting new patients |
Locations
26 N Arsenal Ave
Indianapolis, IN 46201
Phone (317) 423-0123
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | 39003421A | IN | Yes |
Addresses
Primary practice location
6130 Michigan Rd
Indianapolis, IN 46228-1200
Mailing address
6130 Michigan Rd
Indianapolis, IN 46228-1200
Phone (317) 925-2833
Other providers in Indianapolis, IN
- William D. Alexy
- Leonardo Alfaro Briceno
- Anthony Christopher Alfonso
- Cameron Nelson Alford
- Elizabeth N Alford
- Jana Alfrhan
- Sana Alfrhan
- Jeremy W Algate
- Wesam Alhadid
- Dana Alhaffar
All providers in Indianapolis, IN · Mental Health Counselor in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.