Provider Demographics
NPI:1952401549
Name:ANNISON, SHANNON ARMSTRONG (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:ARMSTRONG
Last Name:ANNISON
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 1:36038 WILMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70706-1523
Mailing Address - Country:US
Mailing Address - Phone:225-664-6598
Mailing Address - Fax:
Practice Address - Street 1:36038 WILMINGTON AVE
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70706-1523
Practice Address - Country:US
Practice Address - Phone:225-664-6598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA57271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical