Shannon Colestock

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

128 Cross Keys Rd
Berlin, NJ 08009-9201

Phone

(856) 210-1511

NPI assigned

Jul 19, 2008

Sex

Male

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)

Not enrolled

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

{
    "created_epoch": "1216425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216425600000",
    "number": "1255596243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 CROSS KEYS RD",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080099201",
            "telephone_number": "856-210-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 CROSS KEYS RD",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080099201",
            "telephone_number": "856-210-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLESTOCK",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-19",
        "last_updated": "2008-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Charley
• Rajinder P. Chugh, MD
• Isabelle Catherine Clauss, PA-C
• Michael S Cohen, O.D.
• Erika Colatrella
• Margaret M Coley
• Community Medical Transporters, LLC.
• Richard C Costa, D.O.
• Justin Croak
• Kassidy Lynn D'Amico, MA, LAC

• All providers in Berlin, NJ
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2008; 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.