Provider Demographics
NPI:1720885346
Name:MONTEIRO, SHANNON DESIREE (MA, LMHP-R)
Entity type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:DESIREE
Last Name:MONTEIRO
Suffix:
Gender:
Credentials:MA, LMHP-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3906 POLLYPINE DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-2369
Mailing Address - Country:US
Mailing Address - Phone:757-287-0390
Mailing Address - Fax:
Practice Address - Street 1:3906 POLLYPINE DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-2369
Practice Address - Country:US
Practice Address - Phone:757-287-0390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-01
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704013912101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health