Individual provider · Type 1 NPI

Shannon Tierney

Mental Health Counselor · Coram, NY

NPI number 1053933085 Active

Practice location

3600 Route 112
Coram, NY 11727-4116

Mailing address

14202 20th Ave
Flushing, NY 11351-3000

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X010033-01 (NY)

Mental Health Counselor: Definition to come...

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About NPI 1053933085

Shannon Tierney's National Provider Identifier is 1053933085, issued on May 13, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Coram, NY. The record was last updated on May 13, 2020.