Jennifer Louise Shannon, MSW, LICSW

NPI #1528050812 in Provincetown, Massachusetts

Provider Information

NPI Number: 1528050812
Entity Type: Individual
Name: Jennifer Louise Shannon, MSW, LICSW
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Counselor - Mental Health
Credential: MSW, LICSW
Enumeration Date: Aug 22, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 30 CONWELL ST
Address 2: #1
City: Provincetown
State: Massachusetts
ZIP Code: 02657-1548
Phone: (508) 487-1192

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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