Provider Demographics
NPI:1548809080
Name:FLANIGAN, SHANNON BREANNE (MSW)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:BREANNE
Last Name:FLANIGAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 NEW KARNER RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-3854
Mailing Address - Country:US
Mailing Address - Phone:518-708-9765
Mailing Address - Fax:518-447-0429
Practice Address - Street 1:7 BEVAN ST
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-4104
Practice Address - Country:US
Practice Address - Phone:518-237-4131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker