Kathleen M Shanahan, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

015460 Issued in NY

Practice address

Elm and Carlton Streets
Buffalo, NY 14263

Phone

(716) 845-2300

NPI assigned

Dec 2, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Roswell Park Cancer Institute

  • Multi-Specialty Clinic/Center
  • Buffalo, NY
  • NPI 1720036593
  Medicare reassignment NPD
• Roswell Park Cancer Institute

  • Pharmacy
  • Williamsville, NY
  • NPI 1871379586
  NPD

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1942578174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 AGASSIZ CIR",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142142601",
            "telephone_number": "716-932-2629",
            "fax_number": "716-884-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ELM AND CARLTON STREETS",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "14263",
            "telephone_number": "716-845-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18 Agassiz Cir",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142142601",
            "country_code": "US",
            "telephone_number": "716-932-2629",
            "fax_number": "716-884-0291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANAHAN",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-02",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "015460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohamad Yazan Shamli Oghli
• Sheena Shamoon, M.D
• Emily Shanahan-Bieron, LCSW
• Aaron Michael Shanahan, NP
• Alexandra Shanahan, M.S.ED, CF-SLP
• Kathleen McDonald Shanahan, NP
• Leah Catherine Shanahan, LMSW
• Mackenzie Rose Shanahan, MSW
• Meagan Elizabeth Shanahan
• Teagan Brynn Shanahan, PA

• Psychologist in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.