Shannon Marie Ford

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

06917-L Issued in NV

Practice address

2170 E Harmon Ave
Las Vegas, NV 89119-7840

Phone

(702) 794-0100

NPI assigned

May 5, 2020

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

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.

• Mending Minds LLC

  • Addiction (Substance Use Disorder) Counselor
  • Las Vegas, NV
  • NPI 1902763790
  NPD Authorized official

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1609497288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3097 E WARM SPRINGS RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891203757",
            "telephone_number": "702-291-7482",
            "fax_number": "702-718-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 E HARMON AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891197840",
            "telephone_number": "702-794-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3097 E Warm Springs Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891203757",
            "country_code": "US",
            "telephone_number": "702-291-7482",
            "fax_number": "702-718-6718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORD",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-05",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "06917-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Brandon Ford, DDS
• Roger Ford
• Roi D Ford III
• Sacia Maree Ford
• Samantha Ford
• Steven Ford
• Tammy Jo Ford
• Tiosha Ford
• Tracy Verneil Ford
• Tykeshia Ford

• Addiction (Substance Use Disorder) Counselor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Addiction (Substance Use Disorder) Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.