Individual provider Active NPI

Shannon Leigh Knowlton, L.P.C.

  • Professional Counselor
  • Virginia Beach, VA
National Provider Identifier
1164729554
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701004998 Issued in VA
Practice address
512 S Lynnhaven Rd Ste 101
Virginia Beach, VA 23452-6664
Phone
(757) 306-4232
Fax
(757) 306-4235
NPI assigned
Feb 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701004998 VA Primary

Addresses

Primary practice location

512 S Lynnhaven Rd Ste 101
Virginia Beach, VA 23452-6664

Mailing address

512 S Lynnhaven Rd Ste 101
Virginia Beach, VA 23452-6664
Phone (757) 306-4232

Other practice location 1

281 Independence Blvd
Suite 326
Virginia Beach, VA 23462-2986
Phone (757) 490-0377 ext. 342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 13, 2024 through Nov 13, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0701004998VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Counseling Services Professional Current Accepting new patients

Locations

512 S Lynnhaven Rd
Ste 101
Virginia Beach, VA 23452
Phone (757) 306-4232

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1298246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1164729554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 S LYNNHAVEN RD STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234526664",
            "telephone_number": "757-306-4232",
            "fax_number": "757-306-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 S LYNNHAVEN RD STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234526664",
            "telephone_number": "757-306-4232",
            "fax_number": "757-306-4235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "281 Independence Blvd",
            "address_2": "Suite 326",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234622986",
            "country_code": "US",
            "telephone_number": "757-490-0377 x342",
            "fax_number": "757-497-1327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KNOWLTON",
        "first_name": "SHANNON",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-21",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701004998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.