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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 2 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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