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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 4 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 1366685141 NPPES
Michigan MEDICAID 1912452

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