Individual provider Active NPI

Shannon Jex Sieck, LICSW

  • Clinical Social Worker
  • Lincoln, NE
National Provider Identifier
1104114248
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1494 Issued in NE
Practice address
6600 S 66TH St
Lincoln, NE 68516-3656
Phone
(402) 319-3429
NPI assigned
Jul 11, 2011
Last updated
Jul 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1229 NE
Mental Health Counselor 101YM0800X 4223 NE
Clinical Social Worker 1041C0700X 1494 NE Primary

Addresses

Primary practice location

6600 S 66TH St
Lincoln, NE 68516-3656

Mailing address

6600 S 66TH St
Lincoln, NE 68516-3656
Phone (402) 319-3429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: No
  • 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
I20231204003363 NE Practitioner - Clinical Social Worker 8224486055 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1229NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Omni Behavioral Health CurrentSince Oct 1, 2023 Accepting new patients
Omni Behavioral Health CurrentSince Oct 1, 2023 Accepting new patients

Locations

2300 S 13th St
Lincoln, NE 68502
Phone (402) 474-3322

5115 F St
Omaha, NE 68117
Phone (402) 397-9866

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": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1104114248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S 66TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163656",
            "telephone_number": "402-319-3429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 S 66TH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163656",
            "telephone_number": "402-319-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIECK",
        "first_name": "SHANNON",
        "middle_name": "JEX",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1229",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "4223",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NE",
            "license": "1494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.