Dr. John J Shannon, PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35S1000045200 Issued in NJ

Legal business name

DR. JOHN J SHANNON, PA

Practice address

Two Nawatam Way
Matawan, NJ 07747-3018

Phone

(732) 566-9222

Fax

(732) 566-9298

NPI assigned

Sep 5, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John Joseph Shannon, ED.D. CLINICAL PSYCH

Title

President

Phone

(732) 566-9222

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Counseling Service of Central Jersey Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward M. Merski, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Matawan, NJ
  • NPI 1952455941
  NPD (past)

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346803200000",
    "number": "1942559067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "TWO NAWATAM WAY",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077473018",
            "telephone_number": "732-566-9222",
            "fax_number": "732-566-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TWO NAWATAM WAY",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077473018",
            "telephone_number": "732-566-9222",
            "fax_number": "732-566-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JOHN J SHANNON, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-05",
        "last_updated": "2012-09-05",
        "status": "A",
        "authorized_official_last_name": "SHANNON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-566-9222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D. CLINICAL PSYCH"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35S1000045200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3155706",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Counseling Service of Central Jersey",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kripa Diora
• Shanika Dixon-Glaze, MSW
• Erin Dockery, LAC
• Double Vision, PC
• Downtown Osteoporosis Center
• Olutolase Ebunlomo
• Jessica Echevarria, LCADC
• Edward M Merski Psy D PA
• Eihab Human Services New Jersey, Inc.
• Virginia Ejiofor

• Clinical Psychologist in Matawan, NJ
• Providers in Matawan, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.