Shannon L Grantham is a Clinical in Bastrop, Louisiana. Shannon L Grantham practices all healthcare services and medical treatments related to Clinical. The NPI Number for Shannon L Grantham is 1568633048. The last update date is 2016-09-14.
Shannon L Grantham's current location address is 323 W Walnut Ave, Bastrop, Louisiana. You can contact this provider via phone number 3186659950. The mailing address for Shannon L Grantham is 323 W Walnut Ave, Bastrop, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shannon L Grantham |
|---|---|
| Address | 323 W Walnut Ave, Bastrop, Louisiana |
| Phone Number | 3186659950 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1568633048 |
|---|---|
| Provider Enumeration Date | 2008-03-12 |
| Last Updated Date | 2016-09-14 |
Provider Mailing Address Detail
| Address | 323 W Walnut Ave |
|---|---|
| City | Bastrop |
| State | Louisiana (LA) |
| Post Code | 712204521 |
| Phone Number | 3186659950 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 2907292 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique provider identifier assigned to Shannon L Grantham?
The Shannon L Grantham has been issued the NPI (National Provider Identifier) 1568633048 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Shannon L Grantham?
The Shannon L Grantham is physically situated at 323 W Walnut Ave, in the city of Bastrop, state of LA, with the postal code 712204521.
What is the area of specialization for Shannon L Grantham, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Shannon L Grantham is Clinical, and the corresponding taxonomy code that categorizes this area of expertise is 1041C0700X.
When did the Shannon L Grantham receive its 1568633048?
The Shannon L Grantham was issued its 1568633048 on 2008-03-12, which is the date when the organization was assigned this unique identifier.
As of what date were the Shannon L Grantham's details last updated?
The information pertaining to the Shannon L Grantham, including its address, specialty, and other details, was most recently updated on 2016-09-14.
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