Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Shannon Marie Balaban, PHD

Individual provider Clinical Psychologist · NPI 1093425985

Dr. Shannon Marie Balaban, PHD is a Clinical Psychologist in Phoenix, Arizona. Qualified in 2022, 4 years ago. Practices with Ganesha Institute of Neurology and Psychiatry SC, a 25-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
4
Licensed in
AZ
In the registry since
2022
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

9327 N 3rd St Ste 200
Phoenix, AZ 85020-2473
Phone: (520) 595-5500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1860 W Winchester Rd Ste 106, Libertyville, IL 60048-5312 — (847) 816-6335
  • 4600 Green Bay Rd, Kenosha, WI 53144-1719 — (262) 286-1860

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY-005745 (AZ)

Record details

NPI number1093425985
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorYes
NPI enumeratedDecember 1, 2022
Last updated in NPPESMarch 4, 2025
Certification dateMarch 4, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Ganesha Institute Of Neurology And Psychiatry Sc — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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