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Individual
SHANNON GANTT SHORE
Active
Individual
SHANNON GANTT SHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
34010177A
IN
1041C0700X
Clinical Social Worker
904014279
VA
1041C0700X
Clinical Social Worker
Primary
C007665
NC
1041C0700X
Clinical Social Worker
LC00002032
DC
1041C0700X
Clinical Social Worker
LC21651
ME
Other
Enumeration date
11/17/2011
Last updated
08/05/2026
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