Marisa Shanahan

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

2264 Green Hill Rd
Sebastopol, CA 95472-9034

Phone

(707) 823-3385

NPI assigned

Aug 21, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of LakeGroup PAC ID 2466495429, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• County of Lake

  dba Lake County Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clearlake, CA
  • NPI 1326252271
  Medicare reassignment Care Compare group NPD
• County of Lake

  dba Lake County Behavioral Health Services

  • Community/Behavioral Health Agency
  • Lucerne, CA
  • NPI 1215140066
  NPD
• The Camp Recovery Center, LLC

  dba Azure Acres Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Sebastopol, CA
  • NPI 1568517050
  NPD (past)

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

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1255943080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2264 GREEN HILL RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954729034",
            "telephone_number": "707-823-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2264 GREEN HILL RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954729034",
            "telephone_number": "707-823-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "MARISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-21",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Silvano Constantino Senn, D.D.S.
• Serenity Villa Inc
• Wowlvenn Seward-Katzmiller, MFT
• David Wayne Sexton, MSW
• Ally Shamseldin
• Shannon Coon BSN
• Jessie Rose Shepherd, MFTI
• Britta Shiels, LMFT
• James A Shubin, M.D.
• Matthew Tomasz Shubin, LMFT

• Marriage & Family Therapist in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.