SHANNON ANDREA


Address: 12915 63rd Ave N, Maple Grove, MN 55369-6001
Phone: 9528268424

SHANNON ANDREA (NPI# 1407193766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407193766
Entity Type Individual
Full Name SHANNON ANDREA
Other Name SHANNON HOFFMAN
Credential LPCC
Practice Address 12915 63rd Ave N
Maple Grove
MN 55369-6001
Practice Telephone 9528268424
Practice Fax Number 7633835802
Enumeration Date 2013-01-07
Last Update Date 2013-01-07
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101Y00000X Counselor 535 MN Behavioral Health & Social Service Providers

Office Location

Street Address 12915 63RD AVE N
City MAPLE GROVE
State MN
Zip Code 55369-6001

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932410743 Kyle R Cedermark Psychiatry & Neurology 12915 63rd Ave N, Maple Grove, MN 55369-6001 2010-06-25
1538603683 Paragon Residential Treatment for Youth LLC Psychiatric Residential Treatment Facility 12915 63rd Ave N, Maple Grove, MN 55369-6001 2016-12-08
1710432935 Rebekah Birmingham Counselor 12915 63rd Ave N, Maple Grove, MN 55369-6001 2016-08-17
1093179020 Tracy Kuphal-strand Social Worker 12915 63rd Ave N, Maple Grove, MN 55369-6001 2016-04-06
1689071698 Emily Gutlovics Social Worker 12915 63rd Ave N, Maple Grove, MN 55369-6001 2014-11-20
1124449392 Jody Wallin Social Worker 12915 63rd Ave N, Maple Grove, MN 55369-6001 2013-12-13
1063841385 Anna Shkolnik Johnson Social Worker 12915 63rd Ave N, Maple Grove, MN 55369-6001 2013-11-06
1124367149 Calley Lauren Roers Social Worker 12915 63rd Ave N, Maple Grove, MN 55369-6001 2013-02-12
1346511847 Emily Anne Buell Recreation Therapist 12915 63rd Ave N, Maple Grove, MN 55369-6001 2012-01-16
1578832978 Andrea Rude Psychiatric Hospital 12915 63rd Ave N, Maple Grove, MN 55369-6001 2011-12-14
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1376144188 Bonnie Rose Theis Counselor 24 3rd Ave Ne, Unit B, Osseo, MN 55369 2020-11-06
1356976328 Kirollos Samir Hanna Pharmacist 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 2020-03-10
1396395463 Susan Osborne Technician 9240 Orchid Lane, Maple Grove, MN 55369 2019-09-19
1710537196 Janis Langsdale Technician 11070 108 Avenue North, Maple Grove, MN 55369 2019-09-17
1043724552 Tracey Wahlquist Speech-Language Pathologist 11100 86th Ave N, Maple Grove, MN 55369 2017-11-20
1154860005 Kayla Uptagrafft Specialist/Technologist 9555 Upland Lane Norh, Maple Grove, MN 55369 2017-02-13
1750823324 Jennifer Ranallo Social Worker 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 2016-11-13
1558723999 Debra Grace Boersma Advanced Practice Midwife 9825 Hospital Dr#205, Maple Grove, MN 55369 2016-03-24
1396129433 Maple Grove Smiles Dentistry, PC Dentist 12775 Elm Creek Blvd N, Maple Grove, MN 55369 2015-07-18
1558755900 Krista Newman Counselor 24 3rd St Nw, Unit B, Osseo, MN 55369 2015-03-24
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Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification.
Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1689217226 Diane Sparish Counselor 7835 Main St N Ste 220, Maple Grove, MN 55369-7072 2019-10-28
1134665748 Bristlecone To Go, Inc. Counselor 13700 Reimer Dr N, Suite 220, Maple Grove, MN 55311-4580 2017-01-06
1700284452 Kristine A Doten Counselor 11292 86th Ave N Ste 106, Maple Grove, MN 55369-4510 2014-12-11
1558894162 Lea Atkinson Counselor 10650 County Road 81, Suite 205, Maple Grove, MN 55369-4075 2017-04-10
1407162183 Calli Counseling, Pllc Counselor 11334 86th Ave N, Maple Grove, MN 55369-4528 2010-08-19
1477885184 Jennifer Hocum Atherton Counselor 12918 63rd Ave N, Maple Grove, MN 55369-6001 2010-02-04

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1588278444 Sam Chafos Trewick Counselor 3237 Fremont Ave S, Minneapolis, MN 55408-3531 2020-09-08
1962026781 Dylan Thaemert Counselor 2012 Bryant Ave S Ste 1, Minneapolis, MN 55405-2819 2020-06-08
1134742307 Lyon Counseling LLC Counselor 4707 Highway 61 N # 1029, White Bear Lake, MN 55110-3227 2020-05-22
1457986556 Jon Brookson Engfer Counselor 8609 Lyndale Avenue South, Bloomington, MN 55420 2020-03-09
1831735141 Jon Walter Petersen Counselor 4136 Queen Ave S Apt 100, Minneapolis, MN 55410-1254 2019-11-21
1679118921 Meredith Larson Counselor 5301 Kyler Ave Ne Ste 101, Albertville, MN 55301-4718 2019-11-11
1346883501 Christine Lee Garwick-foley Counselor 10032 Quebec Ave S, Bloomington, MN 55438-2126 2019-10-21
1225687999 Rebecca A Kreger Counselor 902 E 2nd St Ste 260, Winona, MN 55987-2640 2019-09-05
1790332195 Esther Swen Counselor 2827 Newton Ave N, Minneapolis, MN 55411-1142 2019-08-20
1154976926 Isuroon Counselor 1600 E. Lake St., Suite 1, Minneapolis, MN 55407-1884 2019-08-07
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Competitor

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City MAPLE GROVE
Zip Code 55369

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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