Provider Demographics
NPI:1033090931
Name:HOPSON, SHANNON (LLMSW)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:HOPSON
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19807 CRYSTAL LAKE DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-2522
Mailing Address - Country:US
Mailing Address - Phone:248-767-7551
Mailing Address - Fax:
Practice Address - Street 1:19807 CRYSTAL LAKE DR
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-2522
Practice Address - Country:US
Practice Address - Phone:248-767-7551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851118074101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health