Kathleen Bradley Shannon, M.A.

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

15 Jane Jacobs Rd Ste 102
Black Mountain, NC 28711

Phone

(828) 243-7988

NPI assigned

Jun 28, 2010

Last updated

Feb 26, 2020By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2025 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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.

• Real Therapy PLLC

  • Adult Mental Health Clinic/Center
  • Black Mountain, NC
  • NPI 1154168599
  Authorized official Same address or phone

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1639480312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "964 HOLLY RD",
            "city": "BLACK MOUNTAIN",
            "state": "NC",
            "postal_code": "287119709",
            "telephone_number": "828-243-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 JANE JACOBS RD STE 102",
            "city": "BLACK MOUNTAIN",
            "state": "NC",
            "postal_code": "28711",
            "telephone_number": "828-243-7988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1175 Carondelet Dr",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993543300",
            "country_code": "US",
            "telephone_number": "509-943-9104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "KATHLEEN",
        "middle_name": "BRADLEY",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry Alexander Seiler, LCSWA
• Annis Kiber Selig, LMBT
• Andrew Settlemyer, PHARMD
• Renee Patrice Shaffer, FNP-BC
• Mary Shamburger, LMBT
• Sarah M Sheehan
• Crystal Shirk, MS, LAT, ATC
• Alanna Shivone, LMBT
• Clifford Neil Shulman, P.T.
• Anita H Slate, HIS

• Counselor in Black Mountain, NC
• Providers in Black Mountain, NC by specialty
• Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.