Shawn Lonnie Dennis, MASTER LEVEL THERAPY

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1542 Kingsley Ave Ste 136
Orange Park, FL 32073-4547

Phone

(904) 458-7780

Fax

(904) 458-7781

NPI assigned

Aug 19, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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.

• Atlantic Street Center

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1447551221
  NPD (past)

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1760937726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 METRO PKWY STE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169416",
            "telephone_number": "239-236-8784",
            "fax_number": "239-790-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 KINGSLEY AVE STE 136",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734547",
            "telephone_number": "904-458-7780",
            "fax_number": "904-458-7781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2103 S Atlantic St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981443615",
            "country_code": "US",
            "telephone_number": "206-329-2050",
            "fax_number": "206-726-8564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "SHAWN",
        "middle_name": "LONNIE",
        "name_prefix": "Mr.",
        "credential": "MASTER LEVEL THERAPY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-19",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Demarco, PTA
• Patrick J Demarco III, MD
• Joann C Denemark, SLP
• Dennis D. Dewey, M.D., P.a.
• Abigail Dennis
• Silvia Depaz, M.D.
• Edward Descallar, M.D.
• Samuel Desir
• Tosha Marie Devlin, LPN
• Chekelia L Dewese

• Mental Health Counselor in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.