Peaceful Shore Therapy, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PEACEFUL SHORE THERAPY, PLLC

Practice address

11330 Vanstory Dr Ste 109F
Huntersville, NC 28078-8146

Phone

(704) 800-5405

Fax

(833) 519-1059

NPI assigned

May 16, 2022

Organization subpart

No

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

Authorized official

Name

Marissa Schnell, LCSW, LPANPI 1801495288

Title

Owner, Clinical Director

Phone

(719) 310-9411

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marissa Schnell, MA, LPA, MSW, LCSW

  • Clinical Social Worker
  • Denver, NC
  • NPI 1801495288
  NPD Authorized official

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1174260871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8012 NORMAN POINTE DR",
            "city": "DENVER",
            "state": "NC",
            "postal_code": "280377700",
            "telephone_number": "704-800-5405",
            "fax_number": "833-513-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11330 VANSTORY DR STE 109F",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280788146",
            "telephone_number": "704-800-5405",
            "fax_number": "833-519-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL SHORE THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "SCHNELL",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "OWNER, CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "719-310-9411",
        "authorized_official_credential": "LCSW, LPA"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Kathleen Patz, DPT
• Paul a Crandall DMD PA
• Ashley Maria Payne
• Tyesha Kiara Payne
• PBS Diagnostics, P.C.
• Amber Siobhan Pearce, MA, LCMHC
• Pediatric Consultant and Professional Writing Services, PLLC
• Pediatric Feeding and Speech Therapy Associates, PA
• Sheneen Peele
• Aimee Elizabeth Peer, ABA

• Clinical Social Worker in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; 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.