Shannon Connell, PH.D., LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

SHANNON CONNELL, PH.D., LLC

Practice address

36 W 8TH St Ste 200
Holland, MI 49423-2702

Phone

(616) 396-4846

Fax

(616) 396-4846

NPI assigned

Sep 9, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Shannon Connell, PH.D.NPI 1366685141

Title

Clinical Psychologist

Phone

(616) 396-4846

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shannon Connell, PH.D.

  • Clinical Psychologist
  • Holland, MI
  • NPI 1366685141
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1631145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631145600000",
    "number": "1457020877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 W 8TH ST STE 200",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494232702",
            "telephone_number": "616-396-4846",
            "fax_number": "616-396-4846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 W 8TH ST STE 200",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494232702",
            "telephone_number": "616-396-4846",
            "fax_number": "616-396-4846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON CONNELL, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A",
        "authorized_official_last_name": "CONNELL",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "616-396-4846",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaena Freeman, MD PLLC
• Priscilla Shafor, CPRM
• Kruti Shah, DDS
• Richard Shangle
• Shanna Housman LLC
• Charkeia Shannon
• Nicholai Christian Shaw
• India Shear
• Bailey Danielle Shelters, AT, ATC
• Kenedy M Shelton

• Clinical Psychologist in Holland, MI
• Providers in Holland, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.