Shannon Rudy, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

093731 Issued in NY

Practice address

1081 Long Pond Rd Ste 100
Rochester, NY 14626-5002

Phone

(585) 210-8939

Fax

(585) 371-6464

NPI assigned

Nov 1, 2017

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

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.

• Family Counseling Services of Cortland County, Inc.

  • Counselor
  • Cortland, NY
  • NPI 1336163963
  NPD (past)
• Gavia Lifecare Center, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rochester, NY
  • NPI 1710592209
  NPD (past)

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1063924827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 LONG POND RD STE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146265002",
            "telephone_number": "585-210-8939",
            "fax_number": "585-371-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 LONG POND RD STE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146265002",
            "telephone_number": "585-210-8939",
            "fax_number": "585-371-6464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1565 Long Pond Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "14626",
            "country_code": "US",
            "telephone_number": "585-723-7723",
            "fax_number": "585-723-7301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Cedar St",
            "address_purpose": "LOCATION",
            "city": "Oneida",
            "state": "NY",
            "postal_code": "134212111",
            "country_code": "US",
            "telephone_number": "607-753-0234 x162",
            "fax_number": "607-299-4349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDY",
        "first_name": "SHANNON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-01",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "093731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Rudman, CASAC
• A Andrew Rudmann, MD
• Theresa Ann Rudolfs, CASAC-T
• Glenda Rudolph
• Diane C Rudy, PHARMD
• Dylan Max Ruebeck, MD
• Samantha Leigh Rueby, PHARMD
• Erik Rueckmann, MD
• Margaret Hammele Ruehle, L.M.T.
• Phyllis Ruetz, FNP-C

• Social Worker in Rochester, NY
• Providers in Rochester, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; 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.