Provider Demographics
NPI:1659030906
Name:SHAMON, ALLEN (LCSW)
Entity type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:
Last Name:SHAMON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8044 REDBUD VINE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89085-4455
Mailing Address - Country:US
Mailing Address - Phone:702-556-9891
Mailing Address - Fax:
Practice Address - Street 1:8044 REDBUD VINE ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89085-4455
Practice Address - Country:US
Practice Address - Phone:702-556-9891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-14
Last Update Date:2024-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227946101Y00000X
MELC23465101Y00000X
NH4056101Y00000X
NJ44SC06362900101Y00000X
FLTPSW4105101Y00000X
IDMBTSWO-45162101Y00000X
NV11513-C101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor