Shannon Killpack, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LAC-21924 Issued in AZ

Practice address

4641 N 12TH St
Phoenix, AZ 85014-4095

Phone

(505) 681-9581

NPI assigned

Feb 11, 2025

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1578378154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 N 129TH DR",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853405126",
            "telephone_number": "505-681-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850144095",
            "telephone_number": "505-681-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLPACK",
        "first_name": "SHANNON",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-21924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa M. Kill, FNP
• Zachary Killeen, MD
• Richard Killen
• Bethany Mae Killian
• Patti Lynne Killingsworth, M.SC.
• Eileen Frances Kilpatrick, PA-C
• Kara Rene Kilts
• Caroline Kim Kupfer, M.D.
• Alexander Youngwhan Kim, MD, DDS
• Brandon J Kim, DPM

• Mental Health Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.