SHANNON ANN CHURCH LCSW
NPI 1164767778
Social Worker - Clinical in Gulfport, MS

Active since December 07, 2012
1340 BROAD AVE, STE 410, GULFPORT, MS 39501(228) 867-5202(228) 867-5007 Get Directions Write a Review

NPPES record last updated: December 7, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shannon Ann Church Lcsw NPPES

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

SHANNON ANN CHURCH LCSW (NPI 1164767778) is an individual clinical provider in Gulfport, Mississippi, licensed in Mississippi (C2562) and active in the NPI registry since December 2012.

NPPES Registry Identity

NPI1164767778
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSHANNON ANN CHURCHCredential: LCSW
Location Address1340 BROAD AVE, STE 410Gulfport, MS 39501-2404
Mailing Address11150 Highway 49Gulfport, MS 39503-4110 · (228) 867-5202 · Fax (228) 867-5007
Fax(228) 867-5007
Sole ProprietorNo
Enumeration DateDecember 7, 2012
NPI 1164767778 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses Licensed in MS · C2562 Licensed in LA · 2999
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.
1340 BROAD AVE, Gulfport, MS 39501

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Hospitalist
1340 BROAD AVE, SUITE 310
GULFPORT, MS 39501
Surgery
1340 BROAD AVE, SUITE 240
GULFPORT, MS 39501
Clinic/Center (Ambulatory Surgical)
1340 BROAD AVE, SUITE 440
GULFPORT, MS 39501
Radiology (Radiation Oncology)
1340 BROAD AVE, SUITE 140
GULFPORT, MS 39501
Nurse Anesthetist, Certified Registered
1340 BROAD AVE
GULFPORT, MS 39501
Urology
1340 BROAD AVE, SUITE 210
GULFPORT, MS 39501
Internal Medicine (Gastroenterology)
1340 BROAD AVE, SUITE 300
GULFPORT, MS 39501
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1340 BROAD AVE, STE 420
GULFPORT, MS 39501

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 Church's NPI number?

The NPI number for Shannon Church is 1164767778. It was assigned to this individual provider in the NPPES registry on December 7, 2012.

Where is Shannon Church located?

Shannon Church practices at 1340 Broad Ave Ste 410, Gulfport, MS 39501. The listed phone number is (228) 867-5202.

What is Shannon Church's specialty?

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

When was this NPI record last updated?

The NPPES record for Shannon Church was last updated on December 7, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.