Provider Demographics
NPI:1801976501
Name:SHANNON, JEANNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:
Last Name:SHANNON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 PRYTANIA ST
Mailing Address - Street 2:PMB # 416
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-4237
Mailing Address - Country:US
Mailing Address - Phone:504-554-2551
Mailing Address - Fax:504-269-2903
Practice Address - Street 1:1040 CALHOUN ST
Practice Address - Street 2:SETON PAVILLION
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5914
Practice Address - Country:US
Practice Address - Phone:504-554-2551
Practice Address - Fax:504-269-2903
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3147101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health