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Individual
DR. SHANNON COUSINEAU
Active
Individual
DR. SHANNON COUSINEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LICSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
118149
MA
104100000X
Social Worker
C014799
NC
1041C0700X
Clinical Social Worker
118149
MA
1041C0700X
Clinical Social Worker
Primary
C014799
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118149
SOCIAL WORK LICENSE
MA
01
—
C014799
SOCIAL WORK LICENSE
NC
Enumeration date
06/25/2008
Last updated
07/20/2022
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