Provider Demographics
NPI:1326419631
Name:EMMEL, SHANNON (LGSW)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:EMMEL
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1001 CROMWELL BRIDGE RD.
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 CROMWELL BRIDGE RD.
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286
Practice Address - Country:US
Practice Address - Phone:410-337-5523
Practice Address - Fax:410-337-5576
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker