Individual provider · Type 1 NPI
Jennifer Louise Shannon, MSW, LICSW
Mental Health Counselor · Provincetown, MA
NPI number
1528050812
Active
Practice location
30 Conwell St, #1
Provincetown, MA 02657-1548
Fax (508) 487-5813
Mailing address
PO Box 2014
Truro, MA 02666-2014
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 107036 (MA) |
Mental Health Counselor: Definition to come...
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About NPI 1528050812
Jennifer Louise Shannon, MSW, LICSW's National Provider Identifier is 1528050812, issued on Aug 22, 2005. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Provincetown, MA. The record was last updated on Jul 13, 2026.