Kelly Shannon
PHD | Clinical Psychologist | 47+ years Exp
102 E Mulberry Ave, San Antonio
Texas, 78212-2946
210-279-1516 210-733-0141
Maps & DirectionsKelly Shannon is a San Antonio, Texas based psychologist with 47 years of experience in Clinical Psychology. He completed his graduation in 1979. He may accept the Medicare-approved amount. Patients may be billed for more than the Medicare deductible and coinsurance. Active license number of Kelly Shannon is 2-3034 for Clinical Psychology in Texas. His current practice location is 102 E Mulberry Ave, San Antonio. Patients can reach him at 210-279-1516 or can fax him at 210-733-0141. Kelly Shannon is PHD in Clinical Psychology and his NPI number (Unique professional ID assigned by NPPES) is 1699874198.
Kelly Shannon is a mental health professional with highly specialized training in the diagnosis and psychological treatment of mental, behavioral and emotional illnesses, including obsessive-compulsive disorder (OCD). His main focus is on diagnosing and treating mental, emotional, and behavioral disorders. Some of the common disorders that he can treat are learning disabilities, substance abuse, depression, anxiety, and eating disorders.
Complete Profile:
Kelly Shannon speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Kelly Shannon |
| Specialization: | Clinical Psychology |
| Gender: | Male |
| Credentials: | PHD |
| Accepts Medicare Assignment: | May Accept |
| Practice Address: | 102 E Mulberry Ave, San Antonio,
Texas, 78212-2946 |
| Phone: | 210-279-1516 |
| Fax: | 210-733-0141 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 9335111806 |
| Enrollment ID: | I20040806000528 |
| NPI Number: | 1699874198 |
| NPI Enumeration Date: | 21 Sep, 2006 |
| NPI Last Update On: | 24 Mar, 2009 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kelly Shannon are as mentioned below.
| License Number | Specialization | State | Status | |
| 2-3034 | Clinical Psychology | Texas | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Kelly Shannon such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| H00088RY01 | Other | Texas | BCBS - TX |
| 035931704 | Medicaid | Texas | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Kelly Shannon
Po Box 120041,
San Antonio, Texas |
| Zip: | 78212-9241 |
| Phone Number: | 210-279-1516 |
| Fax Number: | 210-733-0141 |
Patients can reach Kelly Shannon at
102 E Mulberry Ave, San Antonio, Texas or can
call to book an appointment on 210-279-1516.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.