Shannon Joelle Whitehead, MS/CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

102014 Issued in TX

Practice address

5263 FM 226
Nacogdoches, TX 75961-7238

Phone

(936) 564-2073

Fax

(936) 564-1250

NPI assigned

May 6, 2022

Last updated

May 6, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1407592165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5263 FM 226",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759617238",
            "telephone_number": "936-564-2073",
            "fax_number": "936-564-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5263 FM 226",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759617238",
            "telephone_number": "936-564-2073",
            "fax_number": "936-564-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "SHANNON",
        "middle_name": "JOELLE",
        "name_prefix": "Mrs.",
        "credential": "MS/CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "102014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Westward Trails Operator LLC (Westward Trails Health and Rehab)
• Josh Wheaton
• Debra L White, D.C.
• Toni Irene White, M.D.
• Brandon Charles Whitehead, PHARMD
• Loyd G. Whitley, M.D.
• Whole Again Counseling and Wellness, LLC (Ginger Stephens, MA, LPC. LCDC)
• Megan Wiggins, CCC/SLP
• Wilbrun Edward Furniss II
• Kathy Wilcox

• Speech-Language Pathologist in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Speech-Language Pathologist in Texas

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