Shannon June Tallon, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MC60757087 Issued in WA

Practice address

19980 10TH Ave NE Ste 204a
Poulsbo, WA 98370-6430

Phone

(360) 621-4837

NPI assigned

Sep 29, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Poulsbo Therapy

  • Mental Health Counselor
  • Poulsbo, WA
  • NPI 1073304010
  NPD Authorized official

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1235509555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19980 10TH AVE NE STE 204A",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706430",
            "telephone_number": "360-621-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19980 10TH AVE NE STE 204A",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706430",
            "telephone_number": "360-621-4837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9485 W Colfax Ave",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "CO",
            "postal_code": "802153918",
            "country_code": "US",
            "telephone_number": "720-951-0331",
            "fax_number": "303-432-5260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18657 State Highway 305 NE Ste 3",
            "address_purpose": "LOCATION",
            "city": "Poulsbo",
            "state": "WA",
            "postal_code": "983709184",
            "country_code": "US",
            "telephone_number": "360-209-9813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALLON",
        "first_name": "SHANNON",
        "middle_name": "JUNE",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-29",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MC60757087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik William Swanson, LMP
• Virginia E Swanson, MD
• Linda Diane Swartz, M.D.
• Angela Nichole Szatkowski, D.O.
• Jack Ronald Tacker, M.D.
• Richard H. Tangen, DDS
• Grant Edward Taylor, D.C.
• Mark Richard Taylor, ANRP, FNP
• Michael Testa, CNOR, RNFA
• Eric R Thanem, LMP

• Mental Health Counselor in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.