Shannon, Katie B
Shannon, Katie B is an sole proprietor health care provider with primary practice located at 2224 1St Ave W Ste 4 , Williston ND 58801-6286. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Shannon, Katie B can be contacted via phone (701) 572-3335.Contact Information
Primary practice address
2224 1St Ave W Ste 4
Williston ND 58801-6286
Phone: (701) 572-3335
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 3671 | North Dakota |
Profile Details
| NPI number | 1295862621 |
|---|---|
| LBN Legal business name | Shannon, Katie B |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 27th, 2007 |
| Last updated | Jan 11th, 2022 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295862621 | NPPES |
| North Dakota | MEDICAID | 54516 | |
| North Dakota | Other | 27774 |
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