Shanna Lee Stack

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-SP-TMP-3159 Issued in MT

Practice address

3031 S Russell St Ste B
Missoula, MT 59801-8523

Phone

(406) 396-4130

Fax

(406) 797-5008

NPI assigned

Jul 24, 2013

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

Other names 1

• Shanna Lee White Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Moving Mountains Therapy Center, PLLC

  • Mental Health Occupational Therapist
  • Missoula, MT
  • NPI 1528526894

  Speech-Language Pathologist

  NPD
• Eat Move Grow LLC

  • Occupational Therapist
  • Missoula, MT
  • NPI 1255889846
  NPD (past)

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1346682911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 S RUSSELL ST STE B",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018523",
            "telephone_number": "406-396-4130",
            "fax_number": "406-797-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 S RUSSELL ST STE B",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018523",
            "telephone_number": "406-396-4130",
            "fax_number": "406-797-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "SHANNA",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-24",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MT",
            "license": "SLP-SP-TMP-3159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNA",
            "last_name": "WHITE",
            "middle_name": "LEE",
            "credential": "CF-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• St. Patrick Hospital and Health Sciences Center
• St. Patrick Hospital Corp
• Jessica Stabnau
• Stacey de Witt LCPC LLC (Stacey M de Witt Sole MBR)
• Stack Speech Therapy Group
• Tori Stahl, ATC
• Briiahna KC Staker
• Karin N. Stallard, MA.AC
• Robert Franklin Stanchfield, MD
• Christa Noel Stanchuk, D.C.

• Speech-Language Pathologist in Missoula, MT
• Providers in Missoula, MT by specialty
• Speech-Language Pathologist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.