Shannon Lee Small, CADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CAC4944

Practice address

248 State St Ste 13B
Ellsworth, ME 04605-1850

Phone

(207) 835-5809

NPI assigned

Mar 27, 2018

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1487159075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 STATE ST STE 13B",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051850",
            "telephone_number": "207-835-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 STATE ST STE 13B",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046051850",
            "telephone_number": "207-835-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "SHANNON",
        "middle_name": "LEE",
        "credential": "CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "CAC4944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karlee Kay Simkowski, DC
• Barbara Sigrid Sinclair, PH.D.
• Elizabeth Sirois, LCSW
• Davor Graham Sklizovic, M.D.
• Mica T. Slaven-Lamothe, LCSW, MHRT-CSP
• Petr Smejkal, MD
• Smile Design Ellsworth, PC
• Brandon R Smith, DPT
• Erin Smith
• Sally Linda Smith, LCSW

• Addiction (Substance Use Disorder) Counselor in Ellsworth, ME
• Providers in Ellsworth, ME by specialty
• Addiction (Substance Use Disorder) Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; 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.