Individual provider Active NPI

Shannon Gore Allen, LCSW, LCAS

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1275106312
Registry record updated Jun 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C016920 Issued in NC
Practice address
1650 Greenfield St
Wilmington, NC 28401-6456
Phone
(910) 798-3500
Fax
(910) 798-7834
NPI assigned
Jul 16, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 27347 NC
Community/Behavioral Health Agency 251S00000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X C016920 NC Primary

Addresses

Primary practice location

1650 Greenfield St
Wilmington, NC 28401-6456

Mailing address

1650 Greenfield St
Wilmington, NC 28401-6456
Phone (910) 798-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
27347NCMDAddiction (Substance Use Disorder) Counselor
C016920NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Works Psychological Center, PLLC Clinical PastSince Jul 1, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748736000000",
    "number": "1275106312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 GREENFIELD ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016456",
            "telephone_number": "910-798-3500",
            "fax_number": "910-798-7834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GREENFIELD ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016456",
            "telephone_number": "910-798-3500",
            "fax_number": "910-798-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "SHANNON",
        "middle_name": "GORE",
        "name_prefix": "Mrs.",
        "credential": "LCSW, LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2025-06-01",
        "certification_date": "2025-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "27347",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C016920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2025; 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.