Active NPI
Shannon Rene Haney-Jenkins, LMFT, LCAS
- Marriage & Family Therapist
- Durham, NC
National Provider Identifier
1346510005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1435
- Practice address
- 2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273 - Phone
- (919) 367-1376
- Fax
- (984) 960-1978
- NPI assigned
- Jan 11, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1435 | NC | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2578 | NC |
Addresses
Primary practice location
2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273
Mailing address
2530 Meridian Pkwy Ste 300
Durham, NC 27713-5273
Phone (919) 367-1376
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 14, 2023 through Dec 14, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2578 | NC | MD | Clinical Psychologist |
| 1435 | NC | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702512000000",
"number": "1346510005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2530 MERIDIAN PKWY STE 300",
"city": "DURHAM",
"state": "NC",
"postal_code": "277135273",
"telephone_number": "919-367-1376",
"fax_number": "984-960-1978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2530 MERIDIAN PKWY STE 300",
"city": "DURHAM",
"state": "NC",
"postal_code": "277135273",
"telephone_number": "919-367-1376",
"fax_number": "984-960-1978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANEY-JENKINS",
"first_name": "SHANNON",
"middle_name": "RENE",
"credential": "LMFT, LCAS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-11",
"last_updated": "2023-12-14",
"certification_date": "2023-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NC",
"license": "1435",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "2578",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.