Maxwell, Shannon Jean

Maxwell, Shannon Jean is an individual health care provider with primary practice located at 115 N 7Th St Ste 6 , Spearfish SD 57783-2710. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Maxwell, Shannon Jean can be contacted via phone (605) 645-0100.

Contact Information

Primary practice address
115 N 7Th St Ste 6 Spearfish SD 57783-2710
Phone: (605) 645-0100
Fax: (605) 717-1009
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 530 South Dakota

Profile Details

NPI number 1790058089
LBN Legal business name Maxwell, Shannon Jean
Credentials PSY.D, LP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 16th, 2012
Last updated Jan 15th, 2024 - about 11 months 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 1790058089 NPPES
South Dakota MEDICAID 2009373

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