Connell, Shannon
Connell, Shannon is an sole proprietor health care provider with primary practice located at 36 W 8Th St Ste 200 , Holland MI 49423-2702. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Connell, Shannon can be contacted via phone (616) 396-4846.Contact Information
Primary practice address
36 W 8Th St Ste 200
Holland MI 49423-2702
Phone: (616) 396-4846
Fax: (616) 396-4846
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6301018872 | Michigan |
Behavioral Health & Social Service Providers / Counseling | 103TC1900X | 6301013914 | Michigan |
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 6301013914 | Michigan |
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6301013914 | Michigan |
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6301013914 | Massachusetts |
Profile Details
NPI number | 1366685141 |
---|---|
LBN Legal business name | Connell, Shannon |
Credentials | PH.D. |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Apr 9th, 2009 |
Last updated | Jul 28th, 2021 - about 3 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1366685141 | NPPES |
Michigan | MEDICAID | 1912452 |
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