National Provider Identifier

Shannon Smith

Shannon Smith is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Rochester, NY and a listed phone number of (585) 200-7106.

NPI 1023583879Rochester, NYMental Health Counselor

Profile Overview

NPI
1023583879
Provider Type
Individual
Primary Specialty
Mental Health Counselor
Enumeration Date
October 09, 2018
Last Updated
October 15, 2021

Practice Location

  • 510 Clinton Sq
  • Rochester, NY 14604-1700

Phone: (585) 200-7106

Specialties

  • Mental Health Counselor (101YM0800X)
  • Behavior Technician (106S00000X)
Full Record
NPI
1023583879
Entity Type
Individual
Last Name
Smith
First Name
Shannon
Mailing Street Address
510 Clinton Sq
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14604-1700
Mailing Country
US
Mailing Phone
(585) 200-7106
Mailing Fax
(973) 253-4500
Practice Street Address
510 Clinton Sq
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14604-1700
Practice Country
US
Practice Phone
(585) 200-7106
Enumeration Date
October 09, 2018
Last Updated
October 15, 2021
Sex
Female
Sole Proprietor
No
Certification Date
October 15, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Mental Health Counselor (101YM0800X), Behavior Technician (106S00000X)