Emma Faye Shannon, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

25047 Issued in MN

Practice address

1502 London Rd Ste 205
Duluth, MN 55812-1788

Phone

(612) 234-4689

Fax

(612) 234-4689

NPI assigned

Apr 17, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Emma Shields-Nordness Former name

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Catalyst Mental Health, GBC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
  • NPI 1134490147
  Medicare reassignment NPD
• Catalyst Mental Health, GBC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mount Dora, FL
  • NPI 1639911167
  NPD

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1013404839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51",
            "city": "VICTORIA",
            "state": "MN",
            "postal_code": "553860051",
            "telephone_number": "952-443-4600",
            "fax_number": "952-443-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 LONDON RD STE 205",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558121788",
            "telephone_number": "612-234-4689",
            "fax_number": "612-234-4689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16180 Hastings Ave SE",
            "address_purpose": "LOCATION",
            "city": "Prior Lake",
            "state": "MN",
            "postal_code": "553729227",
            "country_code": "US",
            "telephone_number": "952-443-4600",
            "fax_number": "952-443-4604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "EMMA",
        "middle_name": "FAYE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-17",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "25047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMMA",
            "last_name": "SHIELDS-NORDNESS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mia Severson
• Sarah Jean Severson, SLP
• Julie A Lunde Sevick, PSYD
• Christine Sgarlata, CNP
• Benjamin Shabb
• Kendra Annette Sharkey
• Maren Kay Sharland, PA-C
• Michael J Sharland, PHD
• Ryan Sharrow, PT
• Jessica Rae Shaughnessy, PT

• Clinical Social Worker in Duluth, MN
• Providers in Duluth, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.