1447294061 NPI number — MRS. SHANNON ALISON HARTMAN-WILSON MA, LMFT,

Table of content: MRS. SHANNON ALISON HARTMAN-WILSON MA, LMFT, (NPI 1447294061)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447294061 NPI number — MRS. SHANNON ALISON HARTMAN-WILSON MA, LMFT,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARTMAN-WILSON
Provider First Name:
SHANNON
Provider Middle Name:
ALISON
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA, LMFT,
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARTMAN
Provider Other First Name:
SHANNON
Provider Other Middle Name:
ALISON
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA,LMFT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447294061
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
29 CAMP SHOAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA ROSA BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32459-0642
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-608-9108
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5410 EAST 30A
Provider Second Line Business Practice Location Address:
SUITE 212
Provider Business Practice Location Address City Name:
SANTA ROSA BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-607-9108
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/15/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  39135 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: 963 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 135JJ . This is a "BLUECROSS BLUESHIELD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".