{"npi":"1275296311","type":"NPI-1","status":"active","name":{"display":"Shannon Kelly","other":[],"first":"SHANNON","last":"KELLY","middle":"GENEEN"},"specialty":{"primary_taxonomy":"1041C0700X","primary_taxonomy_description":"Clinical Social Worker","slug":"clinical-social-worker","schema_org_specialty":null,"all":[{"code":"1041C0700X","description":"Clinical Social Worker","primary":false,"state":"MI","license":"6801115932"},{"code":"1041C0700X","description":"Clinical Social Worker","primary":true,"state":"TX","license":"65961"}]},"addresses":[{"purpose":"LOCATION","street_1":"17490 MEANDERING WAY APT 1207","city":"DALLAS","state":"TX","postal_code":"752526150","country_code":"US","phone":"8309281088"},{"purpose":"MAILING","street_1":"17490 MEANDERING WAY APT 1207","city":"DALLAS","state":"TX","postal_code":"752526150","country_code":"US","phone":"8309281088"}],"license":{"state":"TX","number":"65961"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20211207000629","type_code":"14-80","type_desc":"PRACTITIONER - CLINICAL SOCIAL WORKER","state":"TX","pac_id":"1658761663"},{"enrlmt_id":"I20230617000085","type_code":"14-80","type_desc":"PRACTITIONER - CLINICAL SOCIAL WORKER","state":"MI","pac_id":"1658761663"}]},"enumeration_date":"2021-10-15","last_updated":"2023-10-17","_meta":{"source":"NPPES","snapshot_date":"2023-10-17","doc_url":"https://findmynpi.com/api"}}