Shawna Fanning, LMHC, LADC I, CADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

9880 Issued in MA

Practice address

310 Court St Ste 103
Plymouth, MA 02360-4372

Phone

(339) 526-2109

Fax

(339) 207-0142

NPI assigned

Dec 10, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 12, 2024 through Jan 12, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1386989838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 COURT ST STE 103",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604372",
            "telephone_number": "339-526-2109",
            "fax_number": "339-207-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 COURT ST STE 103",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604372",
            "telephone_number": "339-526-2109",
            "fax_number": "339-207-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNING",
        "first_name": "SHAWNA",
        "credential": "LMHC, LADC I, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-10",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "13481",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "0401-2",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "1078AD",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "9880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doreen Fagerberg, LCSW
• Brian M Faghan, PTA
• Ann Marie Savignano Fahey
• Scott Fairfield, M.D.
• Alyssa Falvey
• Fadi Farah, M.D
• Jeffrey N Farber, M.D.
• Ann Timmons Farr, RN
• Victoria Elizabeth Farrell
• Father Bill'S & Mainspring

• Mental Health Counselor in Plymouth, MA
• Providers in Plymouth, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.

Verify at the official NPI Registry.