Active NPI
Shannon Leighanne Cooper, LCSW
- Clinical Social Worker
- Mount Vernon, ME
National Provider Identifier
1710697438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC25315
- Practice address
- 29 Breezy Acres
Mount Vernon, ME 04352-3534 - Phone
- (207) 994-7146
- NPI assigned
- Dec 5, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC25315 | ME | Primary |
Addresses
Primary practice location
29 Breezy Acres
Mount Vernon, ME 04352-3534
Mailing address
29 Breezy Acres
Mount Vernon, ME 04352-3534
Phone (207) 557-1033
Other names 1
- Mrs. Shannon Leighanne Poling
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
| License | State | Type | Specialty |
|---|---|---|---|
| LC25315 | ME | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Breezy Acres Behavioral Health | Clinical | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765324800000",
"number": "1710697438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 BREEZY ACRES",
"city": "MOUNT VERNON",
"state": "ME",
"postal_code": "043523534",
"telephone_number": "207-557-1033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 BREEZY ACRES",
"city": "MOUNT VERNON",
"state": "ME",
"postal_code": "043523534",
"telephone_number": "207-994-7146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "SHANNON",
"middle_name": "LEIGHANNE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-05",
"last_updated": "2025-12-10",
"certification_date": "2025-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC25315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHANNON",
"last_name": "POLING",
"middle_name": "LEIGHANNE",
"prefix": "MRS.",
"credential": "LCSW",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Mount Vernon, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.