Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Shannon Mandle Kettner, PHD, LSCSW

Individual provider Clinical Social Worker · NPI 1609933449

Dr. Shannon Mandle Kettner, PHD, LSCSW is a Clinical Social Worker in Colorado Springs, Colorado. Licensed in Kansas. Registered with an NPI since 2007.

Licensed in
KS
In the registry since
2007
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

3141 Centennial Blvd
Colorado Springs, CO 80907-4094
Phone: (719) 327-5660
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 1075 (KS)

Record details

NPI number1609933449
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD , LSCSW
Sole proprietorNo
NPI enumeratedJanuary 2, 2007
Last updated in NPPESNovember 17, 2015

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