SHANNON DERFUS (NPI# 1730742792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730742792 |
| Entity Type | Individual |
| Full Name | SHANNON DERFUS |
| Credential | MSE, LPCC, NCC |
| Practice Address |
3450 Oleary Ln Eagan MN 55123-2340 |
| Practice Telephone | 6514540114 |
| Mailing Telephone | 6514540114 |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2019-04-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
MN | Behavioral Health & Social Service Providers |
| Street Address |
3450 OLEARY LN |
| City | EAGAN |
| State | MN |
| Zip Code | 55123-2340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750366167 | Patrice Lauer-roberts | Social Worker | 3450 Oleary Ln, Eagan, MN 55123-2340 | 2005-12-08 |
| 1083224232 | Saoirse Mcmahon | Social Worker | 3450 Oleary Ln, Eagan, MN 55123-2340 | 2020-08-03 |
| 1194334318 | Lisa Joy Rutman | Social Worker | 3450 Oleary Ln, Eagan, MN 55123-2340 | 2020-07-23 |
| 1265065114 | Kaibeh Benson | Nurse Practitioner | 3450 Oleary Ln, Eagan, MN 55123-2340 | 2020-02-19 |
| 1952942476 | Emily J Holton | Counselor | 3450 Oleary Ln, Eagan, MN 55123-2340 | 2019-10-06 |
| 1730733098 | Joshua Hampton Goodwin | Social Worker | 3450 Oleary Ln, Eagan, MN 55123-2340 | 2019-07-25 |
| 1992369664 | Mary Annette Freitag | Counselor | 3450 Oleary Ln, Eagan, MN 55123-2340 | 2019-04-27 |
| 1669930012 | Brian Nelson | Counselor | 3450 Oleary Ln, Eagan, MN 55123-2340 | 2019-03-05 |
| 1891269155 | Elise Broderick Quam | Social Worker | 3450 Oleary Ln, Eagan, MN 55123 | 2019-01-18 |
| 1124599345 | Megan Mcteague | Social Worker | 3450 Oleary Ln, Eagan, MN 55123-2340 | 2018-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053828467 | Hilltop Family Chiropractic Center Pa | Chiropractor | 1121 Town Centre Drive Suite 202, Eagan, MN 55123 | 2018-01-08 |
| 1922452507 | Jacob Zimmerman | Counselor | 3450 O'leary Ln., Eagan, MN 55123 | 2016-04-20 |
| 1316320971 | K-squared Fitness, L.L.C. | Public Health or Welfare | 1100 Cliff Rd, Eagan, MN 55123 | 2015-07-01 |
| 1346683687 | Joshua M Dorn | Allergy & Immunology | 3460 Promenade Ave, Eagan, MN 55123 | 2013-04-16 |
| 1700172350 | Mary Christine Mcnabney | Nurse Practitioner | 610 Opperman Drive, D4 Health Center, Your Wellbeing Health Center, Eagan, MN 55123 | 2011-06-22 |
| 1033353669 | Todd Borstad | Social Worker | 3450 O'leary Lane, Eagan, MN 55123 | 2009-04-27 |
| 1821025271 | Mngi Endoscopy LLC | Clinic/Center | 1185 Town Centre Drive, Eagan, MN 55123 | 2006-06-28 |
| 1780620120 | Cindy Eileen Wood | Audiologist | 3440 Oleary Lane, 240, Eagan, MN 55123 | 2006-06-22 |
| 1609845742 | Jeffery R Dichter | Internal Medicine | 849 Govern Circle, Saint Paul, MN 55123 | 2006-03-14 |
| 1962932491 | Maliah J Mcgraw | Dentist | 1121 Town Centre Dr Ste 200, Eagan, MN 55123 | 2017-06-18 |
| Find all providers in zip 55123 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659906188 | Lotus Counseling Center LLC | Counselor | 4660 Slater Rd Ste 145, Eagan, MN 55122-4047 | 2020-03-04 |
| 1881240927 | Erika Rae Heglund | Counselor | 3450 O Leary Lane, Eagan, MN 55123-5512 | 2019-08-14 |
| 1275073496 | Meagen Sweeney | Counselor | 2100 Silver Bell Rd, Eagan, MN 55122-1024 | 2017-03-07 |
| 1861099194 | Nichole Elizabeth Young | Counselor | 2030 Rahn Way, Eagan, MN 55122-2300 | 2020-10-09 |
| 1164981429 | Tatiana Morris | Counselor | 4141 Old Sibley Memorial Highway, Eagan, MN 55122 | 2019-03-17 |
| 1457830762 | Michelle Retzer | Counselor | 3450 Oleary Ln, Eagan, MN 55123-2340 | 2018-08-08 |
| 1568949774 | Mara Jane Morley | Counselor | 3450 Oleary Ln, Eagan, MN 55123-2340 | 2018-07-20 |
| 1992207096 | Justina Peters | Counselor | 3450 Oleary Ln, Eagan, MN 55123-2340 | 2018-03-05 |
| 1366955254 | Kristy Brecke | Counselor | 2130 Cliff Rd Ste 200, Eagan, MN 55122-2487 | 2017-11-14 |
| 1891142287 | Stephanie Miller | Counselor | 3460 Washington Dr, Suite 110, Eagan, MN 55122-1338 | 2016-05-16 |
| Find all providers in EAGAN | ||||
Please comment or provide details below to improve the information on SHANNON DERFUS.
| 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.