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Contact Information

SHANNON BRUCKNER, LCSW, CAADC
119 SYCAMORE DR
ATHENS, GA30606-3462
 Phone: 864-659-0543
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for SHANNON BRUCKNER · (Female)

NPI Number 1497243836
Status Active
Credentials LCSW, CAADC
Entity Individual
Enumeration date 05/01/2018
Last updated 09/19/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # C0263
  • GA License # CSW006270
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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