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

Individual provider Clinical Social Worker · NPI 1164767778

Shannon Ann Church, LCSW is a Clinical Social Worker in Gulfport, Mississippi. Licensed in Louisiana and Mississippi. Registered with an NPI since 2012.

Licensed in
LA, MS
In the registry since
2012
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

1340 Broad Ave Ste 410
Gulfport, MS 39501-2404
Phone: (228) 867-5202
Fax: (228) 867-5007
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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 C2562 (MS)
Clinical Social Worker Taxonomy 1041C0700X · Licence 2999 (LA)

Record details

NPI number1164767778
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedDecember 7, 2012
Last updated in NPPESDecember 7, 2012

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