Shannon Marie White, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

086570 Issued in NY

Practice address

430 New Park Ave Ste 102
West Hartford, CT 06110-1142

Phone

(585) 553-6370

NPI assigned

Sep 10, 2013

Last updated

Jul 25, 2026By the provider in NPPES

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 names 1

• Shannon Marie Koch Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Supportive Care Psychology of Ny PC

  • Clinical Psychologist
  • Howell, NJ
  • NPI 1104315068

  NY

  Medicare reassignment NPD
• Valera Medical, P.C.

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1437782349
  Medicare reassignment

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784937600000",
    "number": "1770918716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 E MAIN STREET RD",
            "address_2": "SUITE 2",
            "city": "BATAVIA",
            "state": "NY",
            "postal_code": "140203444",
            "telephone_number": "585-344-1421",
            "fax_number": "585-344-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 NEW PARK AVE STE 102",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061101142",
            "telephone_number": "585-553-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-10",
        "last_updated": "2026-07-25",
        "certification_date": "2026-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "13934",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "086570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "KOCH",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samantha Sarah West, MSW INTERN
• Westside Chiropractic LLC
• Ellen Wetherbee-McDevitt, PT
• Elizabeth White, COTA-L
• Nancy L White, N.D.
• Daniel J. Wiener, PH.D.
• Mali Klara Wiener, LCSW
• Schuyler Wiggs
• Bonnie Wilder
• Charles N Wilkinson Jr., DMD

• Clinical Social Worker in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.