Provider Demographics
NPI:1760175418
Name:HAMES, SHANNON ROMINES
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:ROMINES
Last Name:HAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 COURT ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-4336
Mailing Address - Country:US
Mailing Address - Phone:314-322-9596
Mailing Address - Fax:
Practice Address - Street 1:314 COURT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-4336
Practice Address - Country:US
Practice Address - Phone:929-260-1957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health