Jordan Patrick Shannon, PHD, LMHCA, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

61107711 Issued in WA

Practice address

7107 Greenwood Ave N Ste C
Seattle, WA 98103-5071

Phone

(352) 573-8848

NPI assigned

Oct 18, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1942926274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7107 GREENWOOD AVE N STE C",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981035071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7107 GREENWOOD AVE N STE C",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981035071",
            "telephone_number": "352-573-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "JORDAN",
        "middle_name": "PATRICK",
        "credential": "PHD, LMHCA, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "61107711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE COUNSELING SERVICES",
            "identifier": "604954244",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "UnityCollectiveCounseling",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7107 Greenwood Ave N Ste C",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981035071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ann Marie Shankle, MSW, LICSW
• Anna Elizabeth Shanks, ARNP
• Shannon Solie Therapy Incorported
• Shannon Wilson DDS PS
• Douglas Shannon, PA-C
• Margaret Shannon, LMHC
• Michael Brendan Shannon, M.D.
• Michael Caroll Shannon, MD
• Timothy Patrick Shannon, BSN, RN
• Nathan Shapiro-Shellaby, CRNA

• Mental Health Counselor in Seattle, WA
• Providers in Seattle, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.