Shannon York, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY11411 Issued in FL

Practice address

8880 Old Kings Rd S Unit 71
Jacksonville, FL 32257-5313

Phone

(904) 469-6930

NPI assigned

Aug 8, 2017

Sex

Female

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

State licenses

Practice roles

Locations

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.

• Beaches Therapy LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jacksonville Beach, FL
  • NPI 1922471721
  NPD

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1770008963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8880 OLD KINGS RD S UNIT 71",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322575313",
            "telephone_number": "904-469-6930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8880 OLD KINGS RD S UNIT 71",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322575313",
            "telephone_number": "904-469-6930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1552 Roberts Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322503222",
            "country_code": "US",
            "telephone_number": "904-299-3420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YORK",
        "first_name": "SHANNON",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY11411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Yoon
• Michael A Yorio, MD
• Jacqueline Michelle York, PT, DPT
• Jason Edward York, M.D.
• Joshua Terrell York, CNA
• Scott Yorko, D.D.S
• Kaylie Dawn Marie Yost, APRN
• You First Support Services Inc
• Elizabeth Rose Youlio, PA-C
• Kharian Youmans, MD

• Clinical Psychologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.