| Shannon And Associates | |
|
1155 W 3rd Ave Columbus OH 43212-3043 | |
| (614) 297-0422 | |
| (614) 297-1050 |
| Full Name | Shannon And Associates |
|---|---|
| Speciality | Psychologist |
| Location | 1155 W 3rd Ave, Columbus, Ohio |
| Authorized Official Name and Position | Joseph W. Shannon (OWNER) |
| Authorized Official Contact | 6142970422 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shannon And Associates 1155 W 3rd Ave Columbus OH 43212-3043 Ph: (614) 297-0422 | Shannon And Associates 1155 W 3rd Ave Columbus OH 43212-3043 Ph: (614) 297-0422 |
| NPI Number | 1760638654 |
|---|---|
| Provider Enumeration Date | 08/12/2008 |
| Last Update Date | 10/09/2012 |
| Medicare PECOS PAC ID | 0749357614 |
|---|---|
| Medicare Enrollment ID | O20080918000012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760638654 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 3402 (Ohio) | Primary |
| Provider Name | Joseph W Shannon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891797452 PECOS PAC ID: 5294802161 Enrollment ID: I20080918000005 |
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