M Shannon Enterprises

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

M SHANNON ENTERPRISES

Doing business as

Healing Haven Counseling

Practice address

6900 Houston Rd Ste 12
Florence, KY 41042-4891

Phone

(310) 619-8989

NPI assigned

Jun 3, 2022

Last updated

May 26, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joanne Sell

Title

Administrator

Phone

(310) 993-1329

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Healing Haven Counseling Doing business as

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Daugherty, MSW, CSW

  • Clinical Social Worker
  • Florence, KY
  • NPI 1619715778
  NPD
• Melanie R Shannon

  • Professional Counselor
  • Florence, KY
  • NPI 1134630577

  Mental Health

  NPD
• Ellizabeth Williams

  • Professional Counselor
  • Florence, KY
  • NPI 1194616532
  NPD
• Yasmin Asad, LPCA

  • Professional Counselor
  • Florence, KY
  • NPI 1184482903

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685059200000",
    "number": "1366181539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 RIVER RD",
            "city": "HEBRON",
            "state": "KY",
            "postal_code": "410489720",
            "telephone_number": "310-619-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 HOUSTON RD STE 12",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410424891",
            "telephone_number": "310-619-8989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7000 Houston Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "KY",
            "postal_code": "410424874",
            "country_code": "US",
            "telephone_number": "310-619-8989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "M SHANNON ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-03",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A",
        "authorized_official_last_name": "SELL",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "310-993-1329"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366181539",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healing Haven Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Counselor in Florence, KY
• Providers in Florence, KY by specialty
• Mental Health Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; 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.