Shannon L. Stavinoha, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

38174 Issued in TX

Practice address

4131 Spicewood Springs Rd Ste I7
Austin, TX 78759-8659

Phone

(903) 914-0224

NPI assigned

Apr 15, 2019

Last updated

Aug 23, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Ritual Wellness Atx PLLC

  • Psychologist
  • Austin, TX
  • NPI 1932874633
  Authorized official Same address or phone

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1174186274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6705 W HIGHWAY 290 P.O. BOX # 50225",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78735",
            "telephone_number": "903-914-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 SPICEWOOD SPRINGS RD STE I7",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598659",
            "telephone_number": "903-914-0224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 W 38th St Ste 44",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787316319",
            "country_code": "US",
            "telephone_number": "512-469-0889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAVINOHA",
        "first_name": "SHANNON",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "TX",
            "license": "38174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Bridzeke Staton, APRN
• Jennifer C Staudenmyer, PT
• Kori Stauffacher, MA, LPC
• Nicole Christine Stavinoha-Pettit, P.T.
• Donna Stavinoha, PT
• Susan Brown Stavinoha, PA
• Staywell, PLLC (StayWell)
• John Steadman
• Christopher Alan Stearns, MD
• Cristi Stearns, LPC

• Counseling Psychologist in Austin, TX
• Providers in Austin, TX by specialty
• Counseling Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.