Individual provider Active NPI

Amanda Shannon, M.A.

  • Mental Health Counselor
  • Lynden, WA
National Provider Identifier
1417288101
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
506 Grover St Ste 112
Lynden, WA 98264
Phone
(360) 383-8682
Fax
(360) 255-0439
NPI assigned
Jan 20, 2010
Last updated
Aug 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MG 60146874 WA
Mental Health Counselor 101YM0800X Primary
Mental Health Counselor 101YM0800X 61542 CA

Addresses

Primary practice location

506 Grover St Ste 112
Lynden, WA 98264

Mailing address

506 Grover St Ste 112
Lynden, WA 98264-1960
Phone (360) 383-8682

Other practice location 1

316 SE Pioneer Way
Oak Harbor, WA 98277-5716
Phone (360) 389-8735

Other practice location 2

316 SE Pioneer Way
Oak Harbor, WA 98277-5716
Phone (360) 389-8735

Other practice location 3

1050 Larrabee Ave Ste 204
Bellingham, WA 98225-7367
Phone (360) 383-8682

Other identifiers 1

IdentifierTypeStateIssuer
00007301MedicaidCA

Other names 1

  • Amanda Harman Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL ShannonCounseling.org

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MG 60146874WAMDMental Health Counselor
61542CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Counseling LLC Mental Health CurrentSince Aug 11, 2019 Accepting new patients
Hope and Thrive Counseling Mental Health Past Accepting new patients

Locations

1050 Larrabee Ave
Ste 204
Bellingham, WA 98225
Phone (360) 383-8682

506 Grover St
Ste 112
Lynden, WA 98264
Phone (360) 383-8682

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1417288101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 GROVER ST STE 112",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982641960",
            "telephone_number": "360-383-8682",
            "fax_number": "360-255-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 GROVER ST STE 112",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "98264",
            "telephone_number": "360-383-8682",
            "fax_number": "360-255-0439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "316 SE Pioneer Way",
            "address_purpose": "LOCATION",
            "city": "Oak Harbor",
            "state": "WA",
            "postal_code": "982775716",
            "country_code": "US",
            "telephone_number": "360-389-8735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "316 SE Pioneer Way",
            "address_purpose": "LOCATION",
            "city": "Oak Harbor",
            "state": "WA",
            "postal_code": "982775716",
            "country_code": "US",
            "telephone_number": "360-389-8735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 Larrabee Ave Ste 204",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982257367",
            "country_code": "US",
            "telephone_number": "360-383-8682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "AMANDA",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MG 60146874",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "61542",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00007301",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ShannonCounseling.org",
            "affiliation": "N",
            "address_1": "506 Grover St Ste 112",
            "city": "Lynden",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982641960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "HARMAN",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lynden, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.