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

Shannon Ellis

Individual provider Clinical Social Worker · NPI 1417604331

Shannon Ellis is a Clinical Social Worker in Columbus, Mississippi. Licensed in Alabama and Mississippi. Registered with an NPI since 2022.

Licensed in
AL, MS
In the registry since
2022
Specialties on file
2

Practice location Address checks out

75 Wood Glen Ln
Columbus, MS 39705-3273
Phone: (662) 574-2150
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 C11725 (MS)
Clinical Social Worker Taxonomy 1041C0700X · Licence 6518C (AL)

Record details

NPI number1417604331
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 10, 2022
Last updated in NPPESOctober 16, 2025
Certification dateOctober 16, 2025
Mailing address75 Wood Glen Ln, Columbus, MS 39705-3273

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