SHANNON ELLIS
NPI 1417604331
Social Worker - Clinical in Columbus, MS

Active since March 10, 2022
75 WOOD GLEN LN, COLUMBUS, MS 39705(662) 574-2150 Get Directions Write a Review

NPPES record last updated: October 16, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Shannon Ellis NPPES

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

SHANNON ELLIS (NPI 1417604331) is an individual clinical provider in Columbus, Mississippi, licensed in Mississippi (C11725) and active in the NPI registry since March 2022.

NPPES Registry Identity

NPI1417604331
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSHANNON ELLIS
Location Address75 WOOD GLEN LNColumbus, MS 39705-3273
Mailing Address75 Wood Glen LnColumbus, MS 39705-3273 · (662) 574-2150
Sole ProprietorNo
Enumeration DateMarch 10, 2022
Last NPPES UpdateOctober 16, 2025
NPPES CertifiedOctober 16, 2025
NPI 1417604331 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 · C11725 Licensed in AL · 6518C
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.
75 WOOD GLEN LN, Columbus, MS 39705

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 Ellis's NPI number?

The NPI number for Shannon Ellis is 1417604331. It was assigned to this individual provider in the NPPES registry on March 10, 2022.

Where is Shannon Ellis located?

Shannon Ellis practices at 75 Wood Glen Ln, Columbus, MS 39705. The listed phone number is (662) 574-2150.

What is Shannon Ellis'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 Ellis was last updated on October 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.