Individual provider Active NPI

Shannon Lentfer

  • Clinical Social Worker
  • Waterloo, IA
National Provider Identifier
1043981632
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
099899 Issued in IA
Practice address
999 Home PLZ Ste 301
Waterloo, IA 50701-4822
Phone
(319) 299-2864
NPI assigned
Sep 23, 2021
Last updated
Apr 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 099899 IA Primary

Addresses

Primary practice location

999 Home PLZ Ste 301
Waterloo, IA 50701-4822

Mailing address

PO Box 2758
Waterloo, IA 50704-2758
Phone (319) 235-5390

Other practice location 1

3251 W 9th St
Waterloo, IA 50702-5310
Phone (319) 234-2893

Other identifiers 1

IdentifierTypeStateIssuer
0074435MedicaidIA

Other names 1

  • Shannon Vanee Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20240327002627 IA Practitioner - Clinical Social Worker 8022455906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

715 W 1St St
Cedar Falls, IA 50613-2617
Phone (319) 420-2687

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Black Hawk-Grundy Mental Health Center Inc. CurrentSince Sep 1, 2021 Accepting new patients
SJL Therapy LLC Clinical CurrentSince Nov 27, 2024 Accepting new patients

Locations

715 W 1st St
Cedar Falls, IA 50613
Phone (319) 277-1020

3251 W 9th St
Waterloo, IA 50702
Phone (319) 234-2893

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1043981632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2758",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042758",
            "telephone_number": "319-235-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 HOME PLZ STE 301",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507014822",
            "telephone_number": "319-299-2864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3251 W 9th St",
            "address_purpose": "LOCATION",
            "city": "Waterloo",
            "state": "IA",
            "postal_code": "507025310",
            "country_code": "US",
            "telephone_number": "319-234-2893",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LENTFER",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "099899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0074435",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "VANEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.