Shannon Mullally, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301011639 Issued in MI

Practice address

2601 Veterans Dr
Harlingen, TX 78550-8942

Phone

(956) 291-9000

NPI assigned

Nov 15, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Harbor Psychological Associates PC

  • Clinical Psychologist
  • Muskegon, MI
  • NPI 1437285830
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1487727806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 4TH ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494411907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 VETERANS DR",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508942",
            "telephone_number": "956-291-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLALLY",
        "first_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301011639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prasad V Movva, M.D.
• David D Moyer Diener, MD
• MPG Home Health LLC (Boost Home Health Rio Grande Valley East)
• Mt. Sinai LLC
• Aleena Mujahid
• Nancy Copithorne Mullowney, MA,LSLP
• Ike Muniez Jr., PHARM.D.
• Kassandra Munivez
• Muniz Rio Grande Pharmacy LLC
• Muniz Rio Grande Pharmacy LLC (Muniz Rio Grande Pharmacy)

• Clinical Psychologist in Harlingen, TX
• Providers in Harlingen, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.