Provider Demographics
NPI:1073135380
Name:BATTLE, SHANNON JOEY
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:JOEY
Last Name:BATTLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 BOWEN RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-5612
Mailing Address - Country:US
Mailing Address - Phone:240-758-0400
Mailing Address - Fax:
Practice Address - Street 1:4300 BOWEN RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5612
Practice Address - Country:US
Practice Address - Phone:240-758-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor