Individual provider Active NPI

Dawn I Shanklin, LMHC, LCPC

  • Mental Health Counselor
  • Baltimore, MD
National Provider Identifier
1407166176
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
000009377 Issued in MA
Practice address
737 W Lombard St # 425
Baltimore, MD 21201-1009
Phone
(410) 746-0700
NPI assigned
Oct 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LC15026 MD
Mental Health Counselor 101YM0800X 000009377 MA Primary

Addresses

Primary practice location

737 W Lombard St # 425
Baltimore, MD 21201-1009

Mailing address

335 Chandler St
Worcester, MA 01602-3441
Phone (508) 767-3089

Other practice location 1

335 Chandler St
Worcester, MA 01602-3441
Phone (508) 787-3089

Other identifiers 2

IdentifierTypeStateIssuer
000009377OtherMALMHC
LC15026OtherMDLCPC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
000009377MAMDMental Health Counselor
LC15026MDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1407166176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 CHANDLER ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016023441",
            "telephone_number": "508-767-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 W LOMBARD ST # 425",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011009",
            "telephone_number": "410-746-0700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 Chandler St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016023441",
            "country_code": "US",
            "telephone_number": "508-787-3089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANKLIN",
        "first_name": "DAWN",
        "middle_name": "I",
        "name_prefix": "Ms.",
        "credential": "LMHC, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC15026",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "000009377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMHC",
            "identifier": "000009377",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCPC",
            "identifier": "LC15026",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.