Amelia D Shannon, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3602 Issued in CT

Practice address

239 Columbus Ave
New Haven, CT 06519-2230

Phone

(203) 910-0548

NPI assigned

Oct 31, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Naked Truth Life Enrichment Project LLC

  • Community/Behavioral Health Agency
  • North Haven, CT
  • NPI 1265990436
  NPD (past) Authorized official

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1700353455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 COLUMBUS AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06519",
            "telephone_number": "203-910-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 COLUMBUS AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065192230",
            "telephone_number": "203-910-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "AMELIA",
        "middle_name": "D",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "3602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3602",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pegah Shakeraneh, PHARMD
• Omar Yasser Abed Shakhtour, MBBS
• Jackson Christopher Shampo
• Jessica Shank-Coviello, APRN
• Shruti Shankar, MD
• Denise L Shannon, LPN
• Shachar David Shapira, M.D., M.H.A.
• Eugene D Shapiro, MD
• Marc J Shapiro, M.D.
• Catherine Hobbs Sharafanowich, R.PH.

• Mental Health Counselor in New Haven, CT
• Providers in New Haven, CT by specialty
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.