Active NPI
Tammy Shanahan, LCSW
- Mental Health Counselor
- Mayfield, KY
National Provider Identifier
1821034646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1775
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 1775 | KY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Merit Behavioral Associates, Inc | Mental Health | Past | Accepting new patients |
Specialties & licenses 2
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1775 | KY | Primary |
| Clinical Social Worker | 1041C0700X | 1775 | KY |
Addresses
NPPES NPI RegistryPrimary 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| Identifier | Type | State | Issuer |
|---|---|---|---|
| 82000613 | Medicaid | KY |
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.