Provider Demographics
NPI:1528141413
Name:POPE, SHONNA M (LCSW)
Entity type:Individual
Prefix:
First Name:SHONNA
Middle Name:M
Last Name:POPE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 PATTESON DR # 151
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3202
Mailing Address - Country:US
Mailing Address - Phone:571-361-8818
Mailing Address - Fax:
Practice Address - Street 1:215 FALLING WATER LN
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-4550
Practice Address - Country:US
Practice Address - Phone:703-431-8857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0135191041C0700X
VA0039261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical