Kelley, Shannon Kathleen

Kelley, Shannon Kathleen is an sole proprietor health care provider with primary practice located at 713 Harrison St , Syracuse NY 13210-2305. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Kelley, Shannon Kathleen can be contacted via phone (315) 464-7655.

Contact Information

Primary practice address
713 Harrison St Syracuse NY 13210-2305
Phone: (315) 464-7655
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 082228-1 New York
Nursing Service Providers / Registered Nurse 163W00000X 740606 New York
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 403004 New York

Profile Details

NPI number 1902089238
LBN Legal business name Kelley, Shannon Kathleen
Credentials PMHNP, LCSW, CASAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 10th, 2007
Last updated Feb 25th, 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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