Provider Demographics
NPI:1841931367
Name:ROBINSON, SHANNON L (LCSW)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:L
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:LEE
Other - Last Name:CARROLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22455 E VIA DEL RANCHO
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-9697
Mailing Address - Country:US
Mailing Address - Phone:480-332-7155
Mailing Address - Fax:
Practice Address - Street 1:5980 S COOPER RD STE 4
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-5394
Practice Address - Country:US
Practice Address - Phone:480-927-3813
Practice Address - Fax:480-393-4665
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20272104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker