SHANNON THOME-STAPLETON LPC - NPI 1225525199 - Counselor in Loganville, GA

Q: What is Shannon Thome-stapleton's NPI number?

The NPI number for Shannon Thome-stapleton is 1225525199. It was assigned to this individual provider in the NPPES registry on April 17, 2018.

Q: What is Shannon Thome-stapleton's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

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About Shannon Thome-stapleton Lpc NPPES

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

SHANNON THOME-STAPLETON LPC (NPI 1225525199) is an individual professional provider in Loganville, Georgia, licensed in Georgia (LPC010108) and active in the NPI registry since April 2018. She maintains a secondary practice location in Loganville.

NPPES Registry Identity

NPI1225525199

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameSHANNON THOME-STAPLETONCredential: LPC

Location Address678 TOM BREWER RDLoganville, GA 30052-4005

Mailing Address420 Spring PlMonroe, GA 30655-2072 · (404) 563-6600

Phone(770) 554-3599

Sole ProprietorYes

Enumeration DateApril 17, 2018

Last NPPES UpdateMay 2, 20182 updates tracked since enumeration

✔ NPI 1225525199 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in GA · LPC010108

678 TOM BREWER RD, Loganville, GA 30052

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Secondary Practice Location 1

Location 1678 Tom Brewer RdLoganville, GA 30052-4005 · Phone (770) 554-3599

Other Identifiers 1

Medicaid82-5177075GA

Other Providers at the Same Location NPPES 6

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

LOGANVILLE COMMUNITY MINISTRY VILLAGE, INC.

Community/Behavioral Health