Individual
MR. SHANNON THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
667 DELTONA BLVD, DELTONA, FL 32725-8022
(386) 215-5174
(888) 558-2226
Mailing address
5224 W STATE ROAD 46 # 325, SANFORD, FL 32771-9230
(386) 216-5174
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
CBHCMS0102870
FL
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/01/2011
Last updated
03/29/2026
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