Organization
SHANNON JAMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON JAMES LCSW (OWNER)
(414) 336-0525
Entity
Organization
Contact information
Practice address
9730 W BLUEMOUND RD STE 11, WAUWATOSA, WI 53226-4455
(414) 336-0525
(414) 930-2986
Mailing address
918 E NORTH AVE, MILWAUKEE, WI 53212-3448
(414) 336-0525
(414) 930-2986
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10004541
—
WI
Enumeration date
07/20/2020
Last updated
07/20/2020
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