Shannen Anderson, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810008539 Issued in VA

Practice address

386 Stanley St
Fall River, MA 02720-6009

Phone

(508) 679-5222

Fax

(508) 673-3182

NPI assigned

Aug 19, 2020

Last updated

Dec 10, 2024By 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 2

Addresses

Other names 1

• Shannen Gordon Former name

Medicare fee-for-service enrollment

Enrolled in DC

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1548872740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 NORTHVIEW DR",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273321701",
            "telephone_number": "760-883-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "386 STANLEY ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027206009",
            "telephone_number": "508-679-5222",
            "fax_number": "508-673-3182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SHANNEN",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810008539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNEN",
            "last_name": "GORDON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pedro Jorge Anastacio, PHARM D
• Anchor Counseling, LLC
• Anchor Point Counseling
• Amy D Anderson, DO
• Judith C Anderson
• Stephanie A Anderson
• Adolfo S. Andrade, LICSW
• Amelia Marie Andrade, DS
• Gordon D, Andrade, B.S.
• Henry Pina Andrade Jr.

• Clinical Psychologist in Fall River, MA
• Providers in Fall River, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.