Shannon Takoda Connolly, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C.2103752 Issued in OH

Practice address

5701 N High St Ste 308
Worthington, OH 43085-3960

Phone

(614) 406-0299

NPI assigned

Apr 13, 2022

Sex

Female

Sole proprietor

No

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

State licenses

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.

• Bluestone Counseling LLC

  • Mental Health Counselor
  • Worthington, OH
  • NPI 1407266703
  NPD

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

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1285376731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 N HIGH ST STE 308",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853960",
            "telephone_number": "614-406-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 N HIGH ST STE 308",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853960",
            "telephone_number": "614-406-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNOLLY",
        "first_name": "SHANNON",
        "middle_name": "TAKODA",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2103752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Concierge Home Health Services
• Mamadi Bakao Conde
• Dorothy Yvonne Conley
• Mackenzie Conley, CT
• Kathleen Connell, PCC
• Sarah Elizabeth Conroy, DDS
• Devon Wayne Consul, DPM
• Zainab Conte
• Felicia Asunsion Contreras
• Brandon Dennis Cook, DDS, MS

• Mental Health Counselor in Worthington, OH
• Providers in Worthington, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.