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Shannon Phan
NPI 1063368272 · Mental Health Counselor · Fayetteville, NY
Shannon Phan is a Mental Health Counselor provider in Fayetteville, NY (NPI 1063368272).
Provider details
- NPI number
- 1063368272
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- P133718 (NY)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4000 Medical Center Drive
Suite 504
Fayetteville, NY 13066
Phone: (315) 329-2650
Street-level locationGet directions
Mailing address
8584 Mcnamara Dr
Clay, NY 13041-8819
Registry dates
- Enumerated
- 2026-03-09
- Last updated
- 2026-03-09
- Certified
- 2026-03-05
Frequently asked questions
- What is Shannon Phan's NPI number?
- Shannon Phan's National Provider Identifier (NPI) is 1063368272, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Shannon Phan's specialty?
- Shannon Phan is listed in the NPPES registry with a primary specialty of Mental Health Counselor (Behavioral Health & Social Service Providers).
- Where is Shannon Phan located?
- Shannon Phan's practice location on file with NPPES is 4000 Medical Center Drive, Fayetteville, NY 13066.
- What is Shannon Phan's phone number?
- The practice phone number listed in the NPPES registry for Shannon Phan is (315) 329-2650.
- Is Shannon Phan's NPI active?
- Yes — Shannon Phan's NPI (1063368272) is active in the NPPES registry as of the last update on 2026-03-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.