MARISSA CATHERINE SHANNON MFT
NPI 1124355631
Marriage & Family Therapist in Walnut Creek, CA

Q: What is the provider's specialty?

The provider's specialty is Marriage & Family Therapist with taxonomy code 106H00000X.

Active since November 05, 2009Opted out of Medicare · through Feb 14, 2027

1460 MARIA LN STE 300, WALNUT CREEK, CA 94596(925) 644-0400 Get Directions Write a Review

NPPES record last updated: November 17, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Marissa Catherine Shannon Mft NPPES

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

MARISSA CATHERINE SHANNON MFT (NPI 1124355631) is an individual marriage & family therapist in Walnut Creek, California, licensed in California (LMFT53746) and active in the NPI registry since November 2009. She has opted out of Medicare through February 14, 2027.

NPPES Registry Identity

NPI1124355631

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameMARISSA CATHERINE SHANNONCredential: MFT

Location Address1460 MARIA LN STE 300Walnut Creek, CA 94596-5314

Mailing Address1909 Marguerite AvePleasant Hill, CA 94523-2717 · (510) 856-7476

Phone(925) 644-0400

Sole ProprietorYes

Enumeration DateNovember 5, 2009

Last NPPES UpdateNovember 17, 2021

NPPES CertifiedNovember 17, 2021

✔ NPI 1124355631 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

Licenses✔ Licensed in CA · LMFT53746✔ Licensed in CA · IMF 60402

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

1460 MARIA LN STE 300, Walnut Creek, CA 94596

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Marissa Catherine Shannon Mft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 14, 2025 through February 14, 2027.

Opt-Out Effective DateFebruary 14, 2025

Opt-Out In Effect ThroughFebruary 14, 2027Opt-out affidavits renew automatically every two years unless cancelled