Shannon Mary Carres, PA-C
Psychiatry & Neurology, Psychiatry in Marlton, NJ. Individual provider (NPI-1).
NPI number1225604176
StatusActive
Last updated in NPPESJun 29, 2026
Details
- NPI
- 1225604176
- Entity type
- Individual (NPI-1)
- Name
- Shannon Mary Carres
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 1, 2021
- Certification date
- Jun 29, 2026
- Last updated
- Jun 29, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | 9117419 | FL | Yes |
| 363AM0700X | Physician Assistant, Medical | PA9114719 | FL | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
5 Greentree CenterSuite 117
Marlton, NJ 08053-3422
Phone 609-484-0106
Mailing address
3100 17th St Ste ASaint Cloud, FL 34769-6021
Phone 407-892-0009 · Fax 407-892-3285
Other practice locations
3100 17th St Ste A
Saint Cloud, FL 34769-6021
Saint Cloud, FL 34769-6021
Phone 407-892-0009 · Fax 407-892-3285
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