AMELIA D SHANNON


Address: 239 Columbus Ave, New Haven, CT 06519-2230
Phone: 2039100548

AMELIA D SHANNON (NPI# 1700353455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1700353455
Entity Type Individual
Full Name AMELIA D SHANNON
Credential LPC
Practice Address 239 Columbus Ave
New Haven
CT 06519-2230
Mailing Address 239 Columbus Ave
New Haven
CT 06519
Practice Telephone 2039100548
Mailing Telephone 2039100548
Enumeration Date 2018-10-31
Last Update Date 2018-10-31
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
3602 CT Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
CT 3602 05

Office Location

Street Address 239 COLUMBUS AVE
City NEW HAVEN
State CT
Zip Code 06519-2230

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NPI Name Taxonomy Address Enumeration
1255819348 Jordan Ficocelli Nurse Practitioner 800 Howard Ave # 2, New Haven, CT 06519 2018-08-01
1780123414 Claire Louise Hardin General Acute Care Hospital 95 Howard Ave, New Haven, CT 06519 2017-02-14
1467809137 Ana Laura Vives-rodriguez Student in an Organized Health Care Education/Training Program 800 Howard Avenue, Lower Level, Yale Physicians Building, New Haven, CT 06519 2016-05-23
1346607785 Amanda Kayte Corcoran Advanced Practice Midwife 40 Prince St., Suite 207, New Haven, CT 06519 2016-01-15
1720491905 Sara Harcharik Perkins Dermatology 2 Church St S Ste 305, New Haven, CT 06519 2014-06-05
1194136713 Krishan Ratilal Jethwa Radiology 35 Park St Ste Ll507, New Haven, CT 06519 2014-05-16
1235549353 Brandon Michael Kitay Psychiatry & Neurology 184 Liberty St # Lv108, New Haven, CT 06519 2014-04-28
1649526617 Yale New Haven Hospital Student in an Organized Health Care Education/Training Program 330 Cedar St Fmb 107, Yale New Haven Hospital, Dept of Surgery, New Haven, CT 06519 2012-07-27
1669736765 Mayanka Tickoo Internal Medicine 300 Cedar St Fl 4, New Haven, CT 06519 2012-07-03
1730441627 Judith A Ross Physical Therapist 18 Tower Lane, Tower One Tower East, New Haven, CT 06519 2012-06-15
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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1659835452 Olivia V Carney Counselor 355 Alden Ave Apt B, New Haven, CT 06515-2139 2019-01-25
1265928022 Latreece M Mayes-santiago Counselor 107 Carmel St, New Haven, CT 06511-3103 2018-07-05
1164877312 Patricia Marie Jenkins-simmons Counselor 54 William St, 1st Floor, New Haven, CT 06511-4939 2016-04-25
1467817064 Juan Montalvo Counselor 645 Grand Ave, New Haven, CT 06511-5011 2015-12-23
1679938393 New England Counseling & Advocacy Center Counselor 157 Church St, 19th Floor, New Haven, CT 06510-2100 2015-12-22
1669842043 Happy Family Community Services Counselor 530 State St, New Haven, CT 06511-6503 2015-09-29
1205251295 Adrianne Jones Steiner Counselor 58144 Gratiot Ave., New Haven, MI 48048 2014-02-27
1124269832 Ziara Kurys Counselor 446 Blake St # 200, New Haven, CT 06515-1286 2009-03-11
1689819336 Positive Services for Kids, LLC Counselor 1948 Chapel St, New Haven, CT 06515-2211 2008-12-10
1255583571 Erika Ann Collins Counselor 58089 Main St, New Haven, MI 48048-2697 2008-10-17
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Competitor

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City NEW HAVEN
Zip Code 06519

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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