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

Shannon Rose Di Virgilio

Individual provider Professional Counselor · NPI 1629895669

Shannon Rose Di Virgilio is a Mental Health Counselor in Memphis, Tennessee. Qualified in 2025, 1 year ago. Licensed in Tennessee.

Years since qualifying
1
Licensed in
TN
In the registry since
2024
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Practice location Address checks out

324 Night Sail Dr N Apt 301
Memphis, TN 38103-0010
Phone: (706) 889-0383
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 7013 (TN)

Record details

NPI number1629895669
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 23, 2024
Last updated in NPPESJune 20, 2026
Certification dateJune 20, 2026

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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