Shannon M Nilest, M.ED., LPP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

114308 Issued in KY

Practice address

4710 Champions Trace LN
Suite 107
Louisville, KY 40218-3495

Phone

(502) 454-6353

Fax

(502) 459-9209

NPI assigned

Jun 21, 2007

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 names 1

• Ms. Shannon M Mahoney Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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.

• Seven Counties Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Louisville, KY
  • NPI 1598793671

  Psychologist

  NPD (past)

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465171200000",
    "number": "1760688469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MUHAMMAD ALI BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021423",
            "telephone_number": "502-589-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 CHAMPIONS TRACE LN",
            "address_2": "SUITE 107",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402183495",
            "telephone_number": "502-454-6353",
            "fax_number": "502-459-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILEST",
        "first_name": "SHANNON",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "M.ED., LPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2016-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "114308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "MAHONEY",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "M.ED. LPP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samuel S Nikolich
• Nikorb Healthcare, LLC
• Nikorb Medical Services LLC
• Rebecca Lynn Niksich, AUD
• Georgia Ann Niles, ARNP
• Ernesto Nillar-Fonseca, PSY.D.
• Olivia V Nilsson
• Ninety Seventeen Inc
• Ninnieskidds LLC
• Nirvana Healthcare Staffing LLC

• Psychologist in Louisville, KY
• Providers in Louisville, KY by specialty
• Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; 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.