IndividualActive
Shannon Broom, LCSW
NPI 1114639119 · Clinical Social Worker · Jonesboro, GA
Shannon Broom, LCSW is a Clinical Social Worker provider in Jonesboro, GA (NPI 1114639119).
Provider details
- NPI number
- 1114639119
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- License
- ISW03720 (RI)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES 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
630 Mill Creek Trl
Jonesboro, GA 30238-4122
Phone: (251) 604-1522
Approximate (ZIP-level) locationGet directions
Mailing address
630 Mill Creek Trl
Jonesboro, GA 30238-4122
Registry dates
- Enumerated
- 2022-12-21
- Last updated
- 2022-12-21
- Certified
- 2022-12-21
Frequently asked questions
- What is Shannon Broom's NPI number?
- Shannon Broom's National Provider Identifier (NPI) is 1114639119, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Shannon Broom's specialty?
- Shannon Broom is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Shannon Broom located?
- Shannon Broom's practice location on file with NPPES is 630 Mill Creek Trl, Jonesboro, GA 30238-4122.
- What is Shannon Broom's phone number?
- The practice phone number listed in the NPPES registry for Shannon Broom is (251) 604-1522.
- Is Shannon Broom's NPI active?
- Yes — Shannon Broom's NPI (1114639119) is active in the NPPES registry as of the last update on 2022-12-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.