Organization
DR. JOHN J SHANNON, PA
Active
Other names
Counseling Service of Central Jersey
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN JOSEPH SHANNON ED.D. CLINICAL PSYCH (PRESIDENT)
(732) 566-9222
Entity
Organization
Contact information
Practice address
TWO NAWATAM WAY, MATAWAN, NJ 07747-3018
(732) 566-9222
(732) 566-9298
Mailing address
TWO NAWATAM WAY, MATAWAN, NJ 07747-3018
(732) 566-9222
(732) 566-9298
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
35S1000045200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3155706
—
NJ
Enumeration date
09/05/2012
Last updated
09/05/2012
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