Basic Information
| Provider Information | |||||||||
| NPI: | 1538697883 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOOMEY | ||||||||
| FirstName: | SHANNON | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 155 WATERDAM RD STE 220 | ||||||||
| Address2: | |||||||||
| City: | MC MURRAY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153172567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249696970 | ||||||||
| FaxNumber: | 7249696975 | ||||||||
| Practice Location | |||||||||
| Address1: | 159 WATERDAM RD STE 220 | ||||||||
| Address2: | |||||||||
| City: | MC MURRAY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153172576 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249696970 | ||||||||
| FaxNumber: | 7249696975 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2017 | ||||||||
| LastUpdateDate: | 04/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | PC009662 | PA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.