Individual provider Active NPI

Shannon Grant, LPCC

  • Mental Health Counselor
  • Albuquerque, NM
National Provider Identifier
1689878605
Registry record updated Oct 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0101111 Issued in NM
Practice address
3301 Candelaria Rd NE Ste B
Albuquerque, NM 87107-1965
Phone
(505) 880-0100
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0101111 NM Primary

Addresses

Primary practice location

3301 Candelaria Rd NE Ste B
Albuquerque, NM 87107-1965

Mailing address

7027 Montgomery Blvd NE
Suite F
Albuquerque, NM 87109-1589
Phone (505) 220-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0101111NMMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1689878605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7027 MONTGOMERY BLVD NE",
            "address_2": "SUITE F",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871091589",
            "telephone_number": "505-220-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 CANDELARIA RD NE STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871071965",
            "telephone_number": "505-880-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "SHANNON",
        "name_prefix": "Mrs.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0101111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2017; 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.