Bruckner, Shannon

Bruckner, Shannon is an sole proprietor health care provider with primary practice located at 119 Sycamore Dr , Athens GA 30606-3462. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Bruckner, Shannon can be contacted via phone (864) 659-0543.

Contact Information

Primary practice address
119 Sycamore Dr Athens GA 30606-3462
Phone: (864) 659-0543
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X C0263 Georgia
Behavioral Health & Social Service Providers / Clinical 1041C0700X CSW006270 Georgia

Profile Details

NPI number 1497243836
LBN Legal business name Bruckner, Shannon
Credentials LCSW, CAADC
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 1st, 2018
Last updated Sep 19th, 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.

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