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

Shannon Sidney Broom, LCSW

Individual provider Clinical Social Worker · NPI 1114639119

Shannon Sidney Broom, LCSW is a Clinical Social Worker in Jonesboro, Georgia. Practices as a sole proprietor. Licensed in Rhode Island.

Licensed in
RI
In the registry since
2022
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

630 Mill Creek Trl
Jonesboro, GA 30238-4122
Phone: (251) 604-1522
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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 ISW03720 (RI)

Record details

NPI number1114639119
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedDecember 21, 2022
Last updated in NPPESDecember 21, 2022
Certification dateDecember 21, 2022

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