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SHANNON SIDNEY BROOM LCSW
NPI 1114639119
Social Worker - Clinical in Jonesboro, GA

Active since December 21, 2022
630 MILL CREEK TRL, JONESBORO, GA 30238(251) 604-1522 Get Directions Write a Review

NPPES record last updated: December 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shannon Sidney Broom Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON SIDNEY BROOM LCSW (NPI 1114639119) is an individual clinical provider in Jonesboro, Georgia, licensed in Rhode Island (ISW03720) and active in the NPI registry since December 2022.

NPPES Registry Identity

NPI1114639119
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSHANNON SIDNEY BROOMCredential: LCSW
Location Address630 MILL CREEK TRLJonesboro, GA 30238-4122
Mailing Address630 Mill Creek TrlJonesboro, GA 30238-4122 · (251) 604-1522
Phone(251) 604-1522
Sole ProprietorYes
Enumeration DateDecember 21, 2022
NPPES CertifiedDecember 21, 2022
✔ NPI 1114639119 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in RI · ISW03720
Definition
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 interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
630 MILL CREEK TRL, Jonesboro, GA 30238
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Other Identifiers 1

OtherISW03720RI · Lcsw

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Harvard Pilgrim Health Care.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Broom's NPI number?

The NPI number for Shannon Broom is 1114639119. It was assigned to this individual provider in the NPPES registry on December 21, 2022.

Where is Shannon Broom located?

Shannon Broom practices at 630 Mill Creek Trl, Jonesboro, GA 30238. The listed phone number is (251) 604-1522.

What is Shannon Broom's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

What insurance does Shannon Broom accept?

Health plans from Harvard Pilgrim Health Care list Shannon Broom as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shannon Broom was last updated on December 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.