Shannon O'Donnell, LCSW-S, LCDC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

103360 Issued in TX

Practice address

1401 Dezarae Apt 3
San Antonio, TX 78253-5986

Phone

(210) 530-4167

NPI assigned

Feb 24, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shannon Booth Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Soba Texas LLC

  • Substance Abuse Rehabilitation Facility
  • San Antonio, TX
  • NPI 1831520360
  NPD
• Soba Texas LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • San Antonio, TX
  • NPI 1336599182
  NPD (past)

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

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1376817262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 DEZARAE APT 3",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782535986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 DEZARAE APT 3",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782535986",
            "telephone_number": "210-530-4167"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2250 N Veterans Blvd",
            "address_purpose": "LOCATION",
            "city": "Eagle Pass",
            "state": "TX",
            "postal_code": "78852",
            "country_code": "US",
            "telephone_number": "830-757-0117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "SHANNON",
        "credential": "LCSW-S, LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-24",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12064",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "103360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "BOOTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tamanna Shams O'Dea, MD
• Jennifer O'Dell
• Kristen Nicole O'Dell
• Katherine O'Donnell, FNP
• Louise O'Donnell, PH.D.
• Gabriella Garay O'Donoghue, FNP
• Alexandra Michelle O'Gorman
• Gerald Vicent O'Gorman, MD
• Sally Katherine O'Gwin-Gentry, LPC
• Scarlett Nicole O'Hara-Wood, NP

• Social Worker in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.