Jennifer Louise Shannon, MSW, LICSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

107036 Issued in MA

Practice address

30 Conwell St
#1
Provincetown, MA 02657-1548

Phone

(508) 487-1192

Fax

(508) 487-5813

NPI assigned

Aug 22, 2005

Last updated

Jul 13, 2026By the provider in NPPES

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)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gosnold, Inc.

  • Children's Substance Abuse Rehabilitation Facility
  • Falmouth, MA
  • NPI 1639219314
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1528050812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2014",
            "city": "TRURO",
            "state": "MA",
            "postal_code": "026662014",
            "telephone_number": "508-487-1192",
            "fax_number": "508-487-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CONWELL ST",
            "address_2": "#1",
            "city": "PROVINCETOWN",
            "state": "MA",
            "postal_code": "026571548",
            "telephone_number": "508-487-1192",
            "fax_number": "508-487-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "JENNIFER",
        "middle_name": "LOUISE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "107036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seashore Point Wellness and Rehab
• Seashore Point-Deaconess, Inc. (Seashore Point Wellness & Rehabilitation)
• Seashore Pointe Rehab Center LLC
• Seashore Pointe Rehab Center LLC
• Zumm Serrano
• William E Shay, MD
• Brian J Sheerin, LICSW
• Stillwater Therapy LLC
• Stop & Shop Supermarket Company LLC (Stop & Shop Pharmacy #2403)
• Town of Provincetown (Provincetown Fire Department)

• Mental Health Counselor in Provincetown, MA
• Providers in Provincetown, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.