Provider Demographics
NPI:1912592148
Name:RIPANI, SHANNON STONE (LCSW)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:STONE
Last Name:RIPANI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:STONE
Other - Last Name:RIPANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3221 COUNTRY LAWN DR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-1239
Mailing Address - Country:US
Mailing Address - Phone:317-407-5813
Mailing Address - Fax:
Practice Address - Street 1:3221 COUNTRY LAWN DR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-1239
Practice Address - Country:US
Practice Address - Phone:317-407-5813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000063911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical