Carlie Shannon, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

091279 Issued in IA

Practice address

736 Federal St., Ste. 1-103
Davenport, IA 52803-5768

Phone

(309) 684-3212

NPI assigned

Oct 12, 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.

• Bee Well Child and Family Therapy

  • Adolescent and Children Mental Health Clinic/Center
  • Davenport, IA
  • NPI 1467038547
  NPD Authorized official

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1669070777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 FEDERAL ST., STE. 1-103",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528035768",
            "telephone_number": "309-684-3212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 FEDERAL ST., STE. 1-103",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528035768",
            "telephone_number": "309-684-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "CARLIE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "091279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Artika Shah, MD
• Sayed Shah, MD
• Shalom Run Non Emergency Medical Transport LLC
• Shalove Senior Living Community
• Nicolas W Shammas, M.D.
• Mollie Shannon
• Christine M Sharis, MD
• Peter J Sharis, M.D.
• Sharp Hearing Center, LLC
• Mariah Shaver

• Clinical Social Worker in Davenport, IA
• Providers in Davenport, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.