Provider Demographics
NPI:1972887081
Name:SHON, SALLI UNHONG (LCSW, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:SALLI
Middle Name:UNHONG
Last Name:SHON
Suffix:
Gender:F
Credentials:LCSW, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 AVON MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-3745
Mailing Address - Country:US
Mailing Address - Phone:860-740-6949
Mailing Address - Fax:
Practice Address - Street 1:30 AVON MEADOW LN
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3745
Practice Address - Country:US
Practice Address - Phone:860-740-6949
Practice Address - Fax:860-508-2908
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT45251041C0700X
CT447103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical