AMANDA SHANNON M.A. NPI 1417288101

NPI Information

NPI: 1417288101
Provider Name: AMANDA SHANNON, M.A.
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
506 GROVER ST STE 112
LYNDEN, WA
ZIP 98264
Phone: (360) 383-8682
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Amanda Shannon, M.A. is a mental health counselor in Lynden, WA. Amanda Shannon, M.A. NPI is 1417288101. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

506 GROVER ST STE 112
LYNDEN, WA
ZIP 98264
Phone: (360) 383-8682
Fax: (360) 255-0439

The enumeration date for this NPI number is 1/20/2010 and was last updated on 8/6/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	MG 60146874	WASHINGTON	No
2	101YM0800X	Counselor	Mental Health			Yes
3	101YM0800X	Counselor	Mental Health	61542	CALIFORNIA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00007301	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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