Shannon N Leary, LPC, NCC, CSAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701005299 Issued in VA

Practice address

1 Old Oyster Point Rd
Ste. 250
Newport News, VA 23602-7121

Phone

(757) 969-6848

Fax

(757) 969-6849

NPI assigned

Aug 3, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Edward H Tiller PHD PCGroup PAC ID 8426016684, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Edward H Tiller PHD PC

  • Psychologist
  • Williamsburg, VA
  • NPI 1639252919
  Medicare reassignment Care Compare group NPD
• Thimble Shoals Counseling & Therapy Center PC

  • Clinical Social Worker
  • Newport News, VA
  • NPI 1033138227
  NPD (past)

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343952000000",
    "number": "1417203878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 OLD OYSTER POINT RD",
            "address_2": "STE. 250",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236027121",
            "telephone_number": "757-969-6848",
            "fax_number": "757-969-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OLD OYSTER POINT RD",
            "address_2": "STE. 250",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236027121",
            "telephone_number": "757-969-6848",
            "fax_number": "757-969-6849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEARY",
        "first_name": "SHANNON",
        "middle_name": "N",
        "credential": "LPC, NCC, CSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-03",
        "last_updated": "2012-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710102436",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701005299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lead Mental Health Services LLC
• Leap Therapeutic Services
• Dana Olivia Leaphart, LCSW
• Julie Lear, NP
• Learn Me LLC
• Shannon Lebakken, NP-C
• Steven Seth Leblang, MD
• Meagan Ledder, M.S., CCC-SLP
• Anne Lucia Leddy, MD
• Eddie L. Ledford Jr., BC-HIS

• Professional Counselor in Newport News, VA
• Providers in Newport News, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.