Shannon Kelly McFauls, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH17398 Issued in FL

Practice address

463380 State Road 200 Unit B
Yulee, FL 32097-3240

Phone

(904) 500-9808

Fax

(904) 432-0401

NPI assigned

Nov 11, 2012

Last updated

Oct 21, 2024By the provider in NPPES

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

Eligible to order & refer

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

Green means eligible to order or refer.

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.

• My Therapist Shannon LLC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1619777430
  NPD Authorized official
• Secure Connections Therapy Collective PLLC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1801702170
  NPD (past) Authorized official

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

{
    "created_epoch": "1352592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1811231061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 NAVAHO AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322101134",
            "telephone_number": "904-513-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463380 STATE ROAD 200 UNIT B",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320973240",
            "telephone_number": "904-500-9808",
            "fax_number": "904-432-0401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 Navaho Ave",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322101134",
            "country_code": "US",
            "telephone_number": "904-513-0379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2309 Park St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044317",
            "country_code": "US",
            "telephone_number": "904-513-0379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCFAULS",
        "first_name": "SHANNON",
        "middle_name": "KELLY",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-11",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "17398",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Mattingly, DO
• Carrie Anderson Mays
• Devin Gregory McClure, RMHI
• Martha Rose McDonough, D.O.
• Andrea McElreath
• William Aloyisus McLaughlin, M.D.
• Lesley A. McPeak, M.D.
• McPherson Counseling Services, Inc
• McPherson Counseling Services, Inc
• Gail McWhirter, PMHNP

• Mental Health Counselor in Yulee, FL
• Providers in Yulee, 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 Oct 21, 2024; 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.