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

Shannon Brock, LCSWR

Individual provider Clinical Social Worker · NPI 1639362635

Shannon Brock, LCSWR is a Clinical Social Worker in Fort Edward, New York. Licensed in New York. Registered with an NPI since 2007.

Licensed in
NY
In the registry since
2007

Practice location Address checks out

46 Reynolds Rd
Fort Edward, NY 12828-9217
Phone: (518) 573-0239
Fax: (518) 747-2194
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 078314 (NY)

Record details

NPI number1639362635
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSWR
Sole proprietorNo
NPI enumeratedAugust 22, 2007
Last updated in NPPESNovember 21, 2025
Certification dateNovember 21, 2025

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