Individual provider · Type 1 NPI
Shannon Ellis
Clinical Social Worker · Columbus, MS
Practice location
75 Wood Glen Ln
Columbus, MS 39705-3273
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker Primary | 1041C0700X | C11725 (MS) |
| Clinical Social Worker | 1041C0700X | 6518C (AL) |
Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…
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About NPI 1417604331
Shannon Ellis's National Provider Identifier is 1417604331, issued on Mar 10, 2022. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Columbus, MS. The record was last updated on Oct 16, 2025.