Look up the most recent NPI and PECOS records

Melanie R Shannon

Counselor

Behavioral Health & Social Service Providers

6900 Houston Rd Ste 12, Florence, KY 41042-4891

PECOS Enrollment

Based on the most recent information from CMS, provider Melanie R Shannon does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1134630577
Provider Type
Individual
Full Name
Shannon, Melanie R
Gender
Female

Sole Proprietor
Yes
Enumeration Date
10/12/2017
Last Updated
1/31/2024

Contact Information

Practice Location

6900 Houston Rd Ste 12, Florence, KY 41042-4891

(310) 619-8989

Unlisted Fax

Mailing Location

434 Scott St, Covington, KY 41011-2342

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 259926 Kentucky
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License 259926 Kentucky
Code 101YP2500X	Description Counselor Behavioral Health & Social Service Providers	License C.1700453 Ohio

Provider Identifiers

ID	Description	Issuer
ID 259926	Description Other	Issuer LICENSURE Kentucky
ID C.1700453	Description Other	Issuer LICENSURE Ohio

Melanie R Shannon

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Mccaffrey, Emilie Jordyn

Wilson, Bethany

Prior, Nicholas

Howe, Bettie

Gottschall, Brittany

Clark, Amy

Roberts, Lori

Miller, Kristen Osburn

Arsenault, Alexis

Wilson, Brittany Bundy