Shannon, Jacquline Marie
Shannon, Jacquline Marie is an sole proprietor health care provider with primary practice located at 23 Secatogue Ln E , West Islip NY 11795-4719. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Shannon, Jacquline Marie can be contacted via phone (631) 901-3367.Contact Information
Primary practice address
23 Secatogue Ln E
West Islip NY 11795-4719
Phone: (631) 901-3367
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 107578 | New York |
Profile Details
| NPI number | 1548894199 |
|---|---|
| LBN Legal business name | Shannon, Jacquline Marie |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 22nd, 2020 |
| Last updated | Nov 20th, 2023 - about last year |
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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