Shannon Lee Tatum | Ann Arbor, MI • PECOS Search

Shannon Lee Tatum

Social Worker

Behavioral Health & Social Service Providers

122 S Main St, Suite 200, Ann Arbor, MI 48104-1929

(734) 707-7411 (734) 276-8563

PECOS Enrollment

Based on the most recent information from CMS, provider Shannon Lee Tatum 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 yesterday at 9:43 AM.

Profile Details

Provider ID
1972747368
Provider Type
Individual
Full Name
Tatum, Shannon Lee
Title
Ms.
Credential
LMSW

Gender
Female
Sole Proprietor
No
Enumeration Date
4/29/2009
Last Updated
11/22/2016

Contact Information

Practice Location

122 S Main St, Suite 200, Ann Arbor, MI 48104-1929

Unlisted Fax

Mailing Location

606 W Summit St Apt 1, Ann Arbor, MI 48103-3194

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 6801088904 Michigan