Shannon Brooke, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

004769 Issued in CT

Practice address

42 Glenwood Dr
Guilford, CT 06437-2234

Phone

(203) 605-5759

NPI assigned

Nov 29, 2006

Last updated

Aug 20, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Qualified Speech Language Pathologist

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1609943224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 GLENWOOD DR",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372234",
            "telephone_number": "203-605-5759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 GLENWOOD DR",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372234",
            "telephone_number": "203-605-5759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKE",
        "first_name": "SHANNON",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.008210",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "004769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julene Mae Braza, LCSW
• Shawn Edwin Breen, PT
• Paul E. Breton, LCSW
• Michael Brines, M.D.
• Deanna Tear Broderick, RDH
• Pamela Susan Brown, DDS
• Marcia Krekoska Brysh, ATC, LAT
• Linda May Busk, M.S.W.,L.C.S.W.
• Todd Cacopardo, MS,PT
• Peter Henry Cain, DDS

• Speech-Language Pathologist in Guilford, CT
• Providers in Guilford, CT by specialty
• Speech-Language Pathologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.