Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Shannon Park, PSYD

Individual provider Clinical Psychologist · NPI 1871405605

Shannon Park, PSYD is a Clinical Psychologist in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2026.

Licensed in
ID
In the registry since
2026
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

500 W Fort St
Boise, ID 83702-4501
Phone: (208) 422-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 7281830 (ID)

Record details

NPI number1871405605
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD
Sole proprietorNo
NPI enumeratedSeptember 17, 2026
Last updated in NPPESSeptember 17, 2026
Certification dateSeptember 17, 2026

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