SHANNON M WISE MM, MS
NPI 1942040506
Counselor - Mental Health in Fairfax, VA

Active since May 30, 2024
3925 BLENHEIM BLVD STE 52B, FAIRFAX, VA 22030(571) 418-1714 Get Directions Write a Review

NPPES record last updated: May 30, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shannon M Wise Mm, Ms NPPES

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

SHANNON M WISE MM, MS (NPI 1942040506) is an individual mental health provider in Fairfax, Virginia, licensed in Virginia (0704016928) and active in the NPI registry since May 2024. She maintains a secondary practice location in Fairfax.

NPPES Registry Identity

NPI1942040506
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSHANNON M WISECredential: MM, MS
Location Address3925 BLENHEIM BLVD STE 52BFairfax, VA 22030-2426
Mailing Address1295 Mason Mill CtHerndon, VA 20170-5740 · (703) 577-3005
Sole ProprietorYes
Enumeration DateMay 30, 2024
NPPES CertifiedMay 30, 2024
NPI 1942040506 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License Licensed in VA · 0704016928
3925 BLENHEIM BLVD STE 52B, Fairfax, VA 22030

Secondary Practice Location 1

Location 14094 Majestic Ln # 237Fairfax, VA 22033-2104 · Phone (703) 335-6172

Other Providers at the Same Location NPPES 3

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

Counselor (Mental Health)
3925 BLENHEIM BLVD STE 52B
FAIRFAX, VA 22030
Student in an Organized Health Care Education/Training Program
3925 BLENHEIM BLVD STE 52B
FAIRFAX, VA 22030
Student in an Organized Health Care Education/Training Program
3925 BLENHEIM BLVD STE 52B
FAIRFAX, VA 22030

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 Wise's NPI number?

The NPI number for Shannon Wise is 1942040506. It was assigned to this individual provider in the NPPES registry on May 30, 2024.

Where is Shannon Wise located?

Shannon Wise practices at 3925 Blenheim Blvd Ste 52B, Fairfax, VA 22030. The listed phone number is (571) 418-1714.

What is Shannon Wise's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Shannon Wise was last updated on May 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.