Mrs Shannon T Licano, is a
Social Worker based in Phoenix, Arizona. Mrs Shannon T Licano is licensed to practice in Arizona (license number ) and her current practice location is
4449 N 12th St, Phoenix, Arizona. She can be reached at her office (for appointments etc.) via phone at
(602) 279-1427.
NPI number for Mrs Shannon T Licano is 1811018427 and her current mailing address is Po Box 16906, Phoenix, Arizona. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1811018427.
Healthcare Provider's Profile
| Full Name | Mrs Shannon T Licano |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker |
|---|
| Location | 4449 N 12th St, Phoenix, Arizona |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1811018427
- Provider Enumeration Date: 04/02/2007
- Last Update Date: 07/09/2014
Medical Identifiers
Medical identifiers for Mrs Shannon T Licano such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1811018427 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | (Arizona) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Shannon T Licano is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Shannon T Licano,
Po Box 16906,
Phoenix, AZ 85011-6906
Ph: (602) 279-1427 | Mrs Shannon T Licano,
4449 N 12th St,
Phoenix, AZ 85014-4520
Ph: (602) 279-1427 |
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