Individual provider Active NPI

Tammy Shanahan, LCSW

  • Mental Health Counselor
  • Mayfield, KY
National Provider Identifier
1821034646
Registry record updated Aug 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1775 Issued in KY
Practice address
229 W Walnut St
Mayfield, KY 42066-2223
Phone
(270) 251-3666
Fax
(270) 251-3506
NPI assigned
Jun 21, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1775KYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Merit Behavioral Associates, Inc Mental Health PastSince Feb 24, 2003 Accepting new patients

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1775 KY Primary
Clinical Social Worker 1041C0700X 1775 KY

Addresses

NPPES NPI Registry

Primary practice location

229 W Walnut St
Mayfield, KY 42066-2223

Mailing address

229 W Walnut St
PO Box 484
Mayfield, KY 42066-2223
Phone (270) 251-3666

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
82000613MedicaidKY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 10, 2011.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1821034646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 W WALNUT ST",
            "address_2": "PO BOX 484",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420662223",
            "telephone_number": "270-251-3666",
            "fax_number": "270-251-3506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 W WALNUT ST",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420662223",
            "telephone_number": "270-251-3666",
            "fax_number": "270-251-3506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "TAMMY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "1775",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "1775",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82000613",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; 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.