Shannon Backstrom, MHC

Individual provider Active NPI Mental Health Counselor · Danvers, MA

NPI 1851086953 · NPPES record last updated Aug 14, 2024

Key facts

NPI
1851086953
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
75 Lindall St
Danvers, MA 01923-2121
Phone
(978) 767-2847
NPI assigned
Apr 6, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Column Health, LLC Past
since Aug 14, 2023
Accepting new patients
Column Health LLC Past
since Oct 6, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

75 Lindall St
Danvers, MA 01923-2121

Mailing address

75 Lindall St
Danvers, MA 01923-2121
Phone (978) 767-2847

Other providers in Danvers, MA

All providers in Danvers, MA · Mental Health Counselor in Massachusetts

Sources for this page

Verify at the official NPI Registry.