Shannon Louise Vanderkooi, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

54237883501 Issued in UT

Practice address

5698 W Glen Eagle Dr
West Valley City, UT 84128-4013

Phone

(801) 969-4181

NPI assigned

Aug 21, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• LDS Family Services

  dba LDS Family Services W Valley Agency

  • Counselor
  • West Valley City, UT
  • NPI 1548342553
  NPD (past)
• LDS Family Services

  dba LDS Family Services wA Seattle Agency

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Renton, WA
  • NPI 1073726485
  NPD (past)

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1023366127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6671 W HAVEN MAPLE DR",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840812957",
            "telephone_number": "801-304-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5698 W GLEN EAGLE DR",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841284013",
            "telephone_number": "801-969-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERKOOI",
        "first_name": "SHANNON",
        "middle_name": "LOUISE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "54237883501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valley Mental Health Incorporated
• Valley Pharmacy Inc
• Vamos Health Ut
• Amanda Van Ausdal
• Kalee J Vanbeek
• Morgan Vanikiotis
• Andrea Vasquez
• Broc Vaughn
• Jake Doyle Veigel, M.D.
• Shawna Venable, AUD

• Clinical Social Worker in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.