Shannon, Melanie R

Shannon, Melanie R is an sole proprietor health care provider with primary practice located at 6900 Houston Rd Ste 12 , Florence KY 41042-4891. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Shannon, Melanie R can be contacted via phone (310) 619-8989.

Contact Information

Primary practice address
6900 Houston Rd Ste 12 Florence KY 41042-4891
Phone: (310) 619-8989
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 259926 Kentucky
Behavioral Health & Social Service Providers / Professional 101YP2500X C.1700453 Ohio
Behavioral Health & Social Service Providers / Professional 101YP2500X 259926 Kentucky

Profile Details

NPI number 1134630577
LBN Legal business name Shannon, Melanie R
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 12th, 2017
Last updated Jan 31st, 2024 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1134630577 NPPES
Kentucky Other 259926 LICENSURE
Kentucky Other C.1700453 LICENSURE

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