Shannon Leverette Williamson, P.H.D.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2385 Issued in SC

Practice address

310 New Neely Ferry Rd
Mauldin, SC 29662-2617

Phone

(864) 438-0990

Fax

(864) 478-8383

NPI assigned

Sep 27, 2006

Sex

Female

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

Enrolled in SC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Upstate Pediatric Speech Therapy Services

  • Speech-Language Pathologist
  • Mauldin, SC
  • NPI 1952693723
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1275624181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 NEW NEELY FERRY RD",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296622617",
            "telephone_number": "864-438-0990",
            "fax_number": "864-478-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 NEW NEELY FERRY RD",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296622617",
            "telephone_number": "864-438-0990",
            "fax_number": "864-478-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "SHANNON",
        "middle_name": "LEVERETTE",
        "name_prefix": "Dr.",
        "credential": "P.H.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "2385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willbrun Premium Shuttle Service LLC
• Carlin Willett, DNP, APRN, FNP-C
• David P. Willett, MD,PA
• Latonya L Williams
• Rayvnn Williams
• Jennifer Wise
• Sheila Howell Woods, M.D.
• Megan Carmichael Wooles, PA
• Youth and Family Advocacy Services
• Jennifer Elyse Zare, LISW-CP

• Speech-Language Pathologist in Mauldin, SC
• Providers in Mauldin, SC by specialty
• Speech-Language Pathologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.