Active NPI
Shannon Love, LPC-S, NCC, CRC
- Professional Counselor
- Purvis, MS
National Provider Identifier
1154600120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1240
- Practice address
- 89 Brewer Rd
Purvis, MS 39475 - Phone
- (769) 208-3042
- NPI assigned
- Aug 9, 2011
- Last updated
- Feb 6, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 1240 | MS | Primary |
Addresses
Primary practice location
89 Brewer Rd
Purvis, MS 39475
Mailing address
89 Brewer Rd
Purvis, MS 39475-3513
Other practice location 1
20 Bedford Forrest Ln
Hattiesburg, MS 39401-9188
Phone (601) 582-3329
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1240 | MS | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rankin Baptist Association | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Rankin Baptist Association DBA Crossroads Counseling Center
- Counselor
- Pearl, MS
- NPI 1114962560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549411200000",
"number": "1154600120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "89 BREWER RD",
"city": "PURVIS",
"state": "MS",
"postal_code": "394753513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "89 BREWER RD",
"city": "PURVIS",
"state": "MS",
"postal_code": "39475",
"telephone_number": "769-208-3042"
}
],
"practiceLocations": [
{
"address_1": "20 Bedford Forrest Ln",
"address_purpose": "LOCATION",
"city": "Hattiesburg",
"state": "MS",
"postal_code": "394019188",
"country_code": "US",
"telephone_number": "601-582-3329",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LOVE",
"first_name": "SHANNON",
"name_prefix": "Ms.",
"credential": "LPC-S, NCC, CRC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-09",
"last_updated": "2019-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MS",
"license": "1240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Purvis, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.