SHANNON MARIE PENA (NPI# 1861860389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861860389 |
| Entity Type | Individual |
| Full Name | SHANNON MARIE PENA |
| Credential | MS, CRC. LPCA |
| Practice Address |
3410 Healy Dr Ste 203 Winston Salem NC 27103-1568 |
| Practice Telephone | 3367740006 |
| Practice Fax Number | 3367740007 |
| Mailing Telephone | 3362076139 |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-10-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
A10731 | NC | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255677290 | Shannon Michelle Pena | Behavioral Analyst | 11755 Sw 90th St, Suite 201, Miami, FL 33186-2177 | 2012-12-19 |
| Street Address |
3410 HEALY DR STE 203 |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-1568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205232048 | Juan Bautista Santos | Counselor | 3410 Healy Dr Ste 203, Winston Salem, NC 27103-1568 | 2014-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932723301 | Open Hearts Healing Minds | Counselor | 2714 Henning Dr Ste 4, Winston Salem, NC 27106-4502 | 2020-06-02 |
| 1497385595 | Aereil Moore | Counselor | 655 West 4th St, Winston Salem, NC 27101 | 2020-01-17 |
| 1568000610 | Lynn Bentley | Counselor | 4945 Century Oaks Ln, Winston Salem, NC 27106-8721 | 2019-12-18 |
| 1467007468 | Teresa Flake | Counselor | 605 W 24 1/2 St, Winston Salem, NC 27105-4904 | 2019-08-06 |
| 1346711827 | Allison Colette Steinhaus | Counselor | 8025 Northpoint Blvd, Winston Salem, NC 27105 | 2018-12-10 |
| 1750888038 | Moore Ways To Success LLC | Counselor | 500 W 4th St Ste 203g, Winston Salem, NC 27101-2782 | 2018-04-12 |
| 1336643386 | Aileen Imana Lassiter | Counselor | 1462 Cherry St Apt 121, Winston Salem, NC 27105-5888 | 2018-03-22 |
| 1194228049 | Anjanette Gilley Benjamin | Counselor | 650 Highland Ave Ste 1000, Winston Salem, NC 27101 | 2018-03-16 |
| 1538676481 | Aubrey Carr Wendelboe | Counselor | 3000 Bethesda Pl Ste 103, Winston Salem, NC 27103-3323 | 2018-01-01 |
| 1528508330 | Janell Lafaye Jordan | Counselor | 5354 Villas Dr, Winston Salem, NC 27103-6462 | 2017-02-27 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
Please comment or provide details below to improve the information on SHANNON MARIE PENA.
| 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.