Shannon L. Young, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

000748 Issued in CT

Practice address

2 Pomperaug Office Park
Suite 206a
Southbury, CT 06488-2288

Phone

(203) 417-1908

Fax

(203) 791-9094

NPI assigned

Oct 15, 2006

Last updated

Jun 8, 2015By 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

Other identifiers 1

Other names 1

• Shannon Young Tredennick Former name

Medicare fee-for-service enrollment

Enrolled in CT

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

Marriage and Family Therapist

Education

Other, 1995

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1457441735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 POMPERAUG OFFICE PARK",
            "address_2": "SUITE 206A",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882288",
            "telephone_number": "203-417-1908",
            "fax_number": "203-791-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 POMPERAUG OFFICE PARK",
            "address_2": "SUITE 206A",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882288",
            "telephone_number": "203-417-1908",
            "fax_number": "203-791-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SHANNON",
        "middle_name": "L.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-15",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "000748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004187614",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "TREDENNICK",
            "middle_name": "YOUNG",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Woundrx Medical LLC
• Allison Michelle Wozarik, L.C.S.W.
• WRK Ventures, LLC (Urgent Care of Southbury)
• Emma Wyatt, CCC-SLP
• Yeung Business Solutions, LLC (Reliant Pharmacy)
• Mark K Youssef, M.D.
• Rose Yu -Chin, MD FRCP FACP
• Jennifer C. Zaharek, DPT
• John J. Zazzaro, D.M.D.
• Peter Donald Zdankiewicz, M.D.

• Marriage & Family Therapist in Southbury, CT
• Providers in Southbury, CT by specialty
• Marriage & Family Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.