Shannon Gollner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

252640 Issued in KY

Practice address

201 Phillips CT
Owensboro, KY 42303-3772

Phone

(270) 683-6481

Fax

(270) 926-0817

NPI assigned

May 24, 2017

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• The Ky United Methodist Home

  • Clinical Social Worker
  • Owensboro, KY
  • NPI 1730595638
  NPD (past)

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1649708462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 MARYANNE RD",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017420",
            "telephone_number": "16183080310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PHILLIPS CT",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423033772",
            "telephone_number": "270-683-6481",
            "fax_number": "270-926-0817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423012956",
            "country_code": "US",
            "telephone_number": "270-689-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLLNER",
        "first_name": "SHANNON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AK",
            "license": "1005",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "252640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Goerz, LPCA
• Caleb Goetz
• Diane Michelle Goetz, APRN
• Golden Rule Management LLC
• Winona Goldman, RNC
• Richard C. Good, M.D.
• Sarah Jean Goodman
• Namita R Gopal, M.D.
• Catherine Hawes Gordon, PHARMD
• Aaron Charisse Gough, LPCC

• Clinical Social Worker in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.