Shannon Renee Williams, PH.D., LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC1245 Issued in MD

Practice address

9500 Arena Dr Ste 460B
Largo, MD 20774-3755

Phone

(301) 627-0568

Fax

(301) 841-8011

NPI assigned

Jan 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mrs. Shannon Renee Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• SW Therapeutic Services, Inc.

  • Professional Counselor
  • Upper Marlboro, MD
  • NPI 1770637647

  Mental Health

  NPD (past) Authorized official

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1720130297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17203 CLAIRFIELD LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723335",
            "telephone_number": "301-627-0568",
            "fax_number": "301-780-5332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 ARENA DR STE 460B",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207743755",
            "telephone_number": "301-627-0568",
            "fax_number": "301-841-8011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3032 Mitchellville Rd",
            "address_purpose": "LOCATION",
            "city": "Bowie",
            "state": "MD",
            "postal_code": "207161301",
            "country_code": "US",
            "telephone_number": "301-627-0568",
            "fax_number": "301-780-5332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHANNON",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC1245",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC1245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013226800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "SMITH",
            "middle_name": "RENEE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christine Daniel Williams, LCPC
• Erika Williams, M.A. CCC-SLP
• Jacqueline Williams, LCSW-C
• Quenlyn Elise Williams, BSN, RN
• Robyn L Williams, MA
• Sonja Marie Williams, LCMFT
• Barbara Christine Williamson, M.D.
• Cherise Wilson, PHARM.D.
• Tori Ann Wilson, LCPC
• Markia Lashawn Womack, CNM

• Professional Counselor in Largo, MD
• Providers in Largo, MD by specialty
• Professional Counselor in Maryland

• 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.