Shannon Grant LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0129011 Issued in NM

Legal business name

SHANNON GRANT LLC

Practice address

3801 Atrisco Dr NW
Suite F
Albuquerque, NM 87120-1688

Phone

(505) 980-5513

NPI assigned

Sep 30, 2016

Organization subpart

No

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

Authorized official

Name

Shannon Rae Grant, LPCC

Title

Therapist/Owner

Phone

(505) 980-5513

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Hands in the Sand Therapeutics Doing business as

Locations

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475193600000",
    "number": "1295284339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5831 BURGOS AVE NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145497",
            "telephone_number": "505-980-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 ATRISCO DR NW",
            "address_2": "SUITE F",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201688",
            "telephone_number": "505-980-5513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON GRANT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "505-980-5513",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NM",
            "license": "0129011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22988378",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1689878605",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hands in the Sand Therapeutics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rhonda Ashley Shankles, LPN
• Jessica Shanklin
• Elizabeth Shanley, PA
• Megan Shanley, OTR ATP
• Michelle Shanley
• Atanah Shannon
• Ginger Shannon, CPSW CSSS
• Robert M Shannon, MD
• Salina Shannon, PHARM D.
• Samantha Liz Shannon, PA-C

• Community/Behavioral Health Agency in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Community/Behavioral Health Agency in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; 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.