Shanna O'Connor

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CI5190 Issued in NV

Practice address

2780 S Jones Blvd Ste 100a
Las Vegas, NV 89146-5625

Phone

(702) 820-3061

NPI assigned

Oct 18, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lifespan Behavioral Health Nevada PCGroup PAC ID 0749611275, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lifespan Behavioral Health Nevada PC

  • Neurology Physician
  • Henderson, NV
  • NPI 1114547726
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1508377565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9526 BARNSLEY POINT ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891789380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 S JONES BLVD STE 100A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891465625",
            "telephone_number": "702-820-3061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 N Elm St",
            "address_purpose": "LOCATION",
            "city": "Westfield",
            "state": "MA",
            "postal_code": "010853464",
            "country_code": "US",
            "telephone_number": "413-568-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "SHANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-18",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NV",
            "license": "CI5190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie O'Connor
• Marc K O'Connor, M.D.
• Miwa Shiobara O'Connor, DO/MPH
• Nancy O'Connor
• Rhonda O'Connor
• Taylor Shay O'Connor
• Caasi O'Day, MSW, LCSW
• O'Deane & Associates, Inc.
• Janell Rae O'Dell
• Thorn O'Dell

• Professional Counselor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Professional Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.