MS. SHANNON JOLLY (NPI# 1477009041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1477009041 |
Entity Type | Individual |
Full Name | MS. SHANNON JOLLY |
Credential | LCSW |
Practice Address |
1250 W Ironwood Dr Ste 335 Coeur D Alene ID 83814-2682 |
Practice Telephone | 2086671174 |
Practice Fax Number | 2086671175 |
Mailing Telephone | 2086671174 |
Mailing Fax Number | 2086671175 |
Enumeration Date | 2016-09-01 |
Last Update Date | 2020-04-24 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
Y | 1041C0700X |
Social Worker Specialization: Clinical |
LCSW-36039 | ID | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ID | PROFESSIONAL STATE LICENSE | LCSW-36039 | 01 |
UT | UTAH LICENSE | 8139486-3501 | 01 |
Street Address |
1250 W IRONWOOD DR STE 335 |
City | COEUR D ALENE |
State | ID |
Zip Code | 83814-2682 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982235982 | Jolly Counseling Services Pllc | Social Worker | 1250 W Ironwood Dr Ste 335, Coeur D Alene, ID 83814-2679 | 2020-01-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
Find all providers in zip 83814 |
Taxonomy Code | 1041C0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Social Worker |
Specialization | Clinical |
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, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497377469 | Raising Resilience Holistic Mental Wellness Inc | Social Worker | 610 W Hubbard St Ste 226, Coeur D Alene, ID 83814-2200 | 2020-05-13 |
1952823148 | Amy Michelle Jenkins | Social Worker | 1115 W Ironwood Dr Ste A, Coeur D Alene, ID 83814-4937 | 2017-07-10 |
1679937437 | Jason Fredrick Bradfish | Social Worker | 118 N 7th St Ste C3, Coeur D Alene, ID 83814-2736 | 2016-04-07 |
1912348186 | Bailey Jennette White | Social Worker | 1105 W Ironwood Dr Lowr Level, Coeur D Alene, ID 83814 | 2013-07-16 |
1679824965 | Joy'l Jenkins | Social Worker | 1620 Northwest Blvd Ste 101, Coeur D Alene, ID 83814-2488 | 2012-09-26 |
1013277888 | Donna Colberg | Social Worker | 6050 E Kingswood Ln, Coeur D Alene, ID 83814-5263 | 2012-05-25 |
1649568262 | Paul A Grayhek | Social Worker | 1406 N Galena Dr, Coeur D Alene, ID 83814-5990 | 2011-07-17 |
1285933358 | Kathleen Fairbanks | Social Worker | 401 1/2 E Sherman Ave Ste 203, Coeur D Alene, ID 83814-2745 | 2011-03-15 |
1578869780 | Sheri Starbird Weistaner | Social Worker | 602 E Garden Ave Ste 5, Coeur D Alene, ID 83814-2945 | 2011-02-04 |
1093036147 | Jud Eugene Leifheit | Social Worker | 1110 W Park Pl Ste 305, Coeur D Alene, ID 83814-2784 | 2010-06-11 |
Find all providers in COEUR D ALENE |
City | COEUR D ALENE |
Zip Code | 83814 |
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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.