Provider Demographics
NPI:1063047868
Name:CURRY-IZZO, SHANNON (MHC-P)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:CURRY-IZZO
Suffix:
Gender:F
Credentials:MHC-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 LEYDECKER RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3753
Mailing Address - Country:US
Mailing Address - Phone:716-949-4387
Mailing Address - Fax:
Practice Address - Street 1:3176 ABBOTT RD UNIT 500
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1069
Practice Address - Country:US
Practice Address - Phone:716-822-2117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011029-02101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health