Active NPI
Jolynne Z Shannon, LCSW
- Clinical Social Worker
- Lebanon, PA
National Provider Identifier
1548616683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW018509
- Practice address
- 1142 Harvest Dr
Lebanon, PA 17046-1574 - Phone
- (717) 269-6451
- NPI assigned
- May 8, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW018509 | PA | Primary |
Addresses
Primary practice location
1142 Harvest Dr
Lebanon, PA 17046-1574
Mailing address
1142 Harvest Dr
Lebanon, PA 17046-1574
Phone (717) 269-6451
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2026 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639612800000",
"number": "1548616683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1142 HARVEST DR",
"city": "LEBANON",
"state": "PA",
"postal_code": "170461574",
"telephone_number": "717-269-6451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1142 HARVEST DR",
"city": "LEBANON",
"state": "PA",
"postal_code": "170461574",
"telephone_number": "717-269-6451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNON",
"first_name": "JOLYNNE",
"middle_name": "Z",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-08",
"last_updated": "2021-12-16",
"certification_date": "2021-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW018509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.