Bennett, Shannon M

Bennett, Shannon M is an sole proprietor health care provider with primary practice located at 8745 County Road 9 S , Alamosa CO 81101-9610. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Bennett, Shannon M can be contacted via phone (719) 589-3671.

Contact Information

Primary practice address
8745 County Road 9 S Alamosa CO 81101-9610
Phone: (719) 589-3671
Fax: (719) 589-9136
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 603 Colorado

Profile Details

NPI number 1902921356
LBN Legal business name Bennett, Shannon M
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 21st, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902921356 NPPES
Colorado MEDICAID 04140091

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