Individual provider Active NPI

Shannon Crim-Mosey, L.C.S.W.

  • Mental Health Counselor
  • Apopka, FL
National Provider Identifier
1013169333
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW8372 Issued in FL
Practice address
1117 Leyland Court
Apopka, FL 32712
Phone
(407) 814-7631
NPI assigned
Oct 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW8372 FL
Mental Health Counselor 101YM0800X SW8372 FL Primary

Addresses

Primary practice location

1117 Leyland Court
Apopka, FL 32712

Mailing address

1117 Leyland Court
Apopka, FL 32712
Phone (407) 814-7631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140715001688 FL Practitioner - Clinical Social Worker 1557586195 Reassigns benefits to 1 organization
Practice locations: Winter Garden, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Resource Services, Inc.Group PAC ID 3779884093, 30 clinicians

Practice addresses (Care Compare)

13350 W Colonial Dr
Suite 340
Winter Garden, FL 34787-3977
Phone (407) 654-4433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW8372FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Resource Services, Inc. CurrentSince Aug 1, 2016 Accepting new patients

Locations

13350 W Colonial Dr
Ste 340
Winter Garden, FL 34787
Phone (407) 654-4433

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1013169333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 LEYLAND COURT",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "32712",
            "telephone_number": "407-814-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 LEYLAND COURT",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "32712",
            "telephone_number": "407-814-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIM-MOSEY",
        "first_name": "SHANNON",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8372",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW8372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

Verify at the official NPI Registry.