Individual provider Active NPI

Shawna Marshall, MA, LPCC

  • Professional Counselor
  • Luverne, MN
National Provider Identifier
1053970707
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC02110 Issued in MN
Practice address
118 W Main St
Luverne, MN 56156-1829
Phone
(507) 449-6105
Fax
(507) 449-6106
NPI assigned
Jun 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC02110 MN Primary

Addresses

Primary practice location

118 W Main St
Luverne, MN 56156-1829

Mailing address

316 Oak Dr
Luverne, MN 56156-1791
Phone (507) 920-3441

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240417003459 MN Practitioner - Mental Health Counselor 5799135265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Luverne CounselingGroup PAC ID 0345665519, 2 clinicians

Practice addresses (Care Compare)

118 W Main St
Luverne, MN 56156-1829
Phone (507) 449-6105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2110MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Luverne Counseling CurrentSince Jan 1, 2024 Accepting new patients
Southwestern Mental Health Center Inc PastSince Aug 15, 2016 Accepting new patients

Locations

118 W Main St
Luverne, MN 56156
Phone (507) 449-6105

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1053970707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 OAK DR",
            "city": "LUVERNE",
            "state": "MN",
            "postal_code": "561561791",
            "telephone_number": "507-920-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 W MAIN ST",
            "city": "LUVERNE",
            "state": "MN",
            "postal_code": "561561829",
            "telephone_number": "507-449-6105",
            "fax_number": "507-449-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "SHAWNA",
        "credential": "MA, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC02110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Luverne, MN

Sources for this page

Verify at the official NPI Registry.