Provider Demographics
NPI:1740876861
Name:HOWELL, SHANNON K (LCSW)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:K
Last Name:HOWELL
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 1:209 SEQUOYAH ST
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-9209
Mailing Address - Country:US
Mailing Address - Phone:913-706-4779
Mailing Address - Fax:
Practice Address - Street 1:209 SEQUOYAH ST
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-9209
Practice Address - Country:US
Practice Address - Phone:913-706-4779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical