Patrick Shannon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

BBH-LCSW-LIC-48341 Issued in MT

Practice address

3700 S Russell St Ste B110
Missoula, MT 59801-8574

Phone

(406) 763-6611

Fax

(406) 721-5072

NPI assigned

Mar 3, 2021

Last updated

Apr 21, 2021By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Patrick Shannon, LCSW, PLLC

  • Clinical Social Worker
  • Missoula, MT
  • NPI 1619644929
  Authorized official Same address or phone

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1326633207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598060801",
            "telephone_number": "208-651-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 S RUSSELL ST STE B110",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018574",
            "telephone_number": "406-763-6611",
            "fax_number": "406-721-5072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 W Kent Avenue",
            "address_2": "#801",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "59801",
            "country_code": "US",
            "telephone_number": "406-763-6611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "PATRICK",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-48341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Settevendemie, PSYD
• Sydney Diann Seyfert, NP
• SFS PHD Inc
• Gregory F Shanks, MA, LCPC
• Shannon Noon, LCPC, LLC
• Shape
• Pamela Jean Shapiro, APRN
• Brian Jerome Sharkey Jr., LCPC
• Michael Shaw, PCLC
• Sidney L Shaw, LCPC

• Clinical Social Worker in Missoula, MT
• Providers in Missoula, MT by specialty
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.