Provider Demographics
NPI:1942316120
Name:HAMRICK, SHANNON MICHELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:MICHELLE
Last Name:HAMRICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:
Other - Last Name:HAMRICK-KRAGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4305 MACARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-6511
Mailing Address - Country:US
Mailing Address - Phone:214-526-4525
Mailing Address - Fax:214-520-6468
Practice Address - Street 1:4305 MACARTHUR AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-6511
Practice Address - Country:US
Practice Address - Phone:214-526-4525
Practice Address - Fax:214-520-6468
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX348051041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical