Individual provider Active NPI

Shannon Roehm, LCSW

  • Clinical Social Worker
  • Saline, MI
National Provider Identifier
1104376250
Registry record updated Jul 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801118677 Issued in MI
Practice address
400 W Russell St
Saline, MI 48176-1183
Phone
(734) 429-1660
Fax
(734) 429-0023
NPI assigned
Oct 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2026

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 6801118677 MI Primary

Addresses

Primary practice location

400 W Russell St
Saline, MI 48176-1183

Mailing address

400 W Russell St
Saline, MI 48176-1183
Phone (734) 429-1660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240801002250 MI Practitioner - Clinical Social Worker 3971040452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

2350 Green Rd
Suite 150 160
Ann Arbor, MI 48105-1599
Phone (734) 285-8282

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801118677MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC Clinical CurrentSince Aug 23, 2024 Accepting new patients
Acpc PLLC CurrentSince Sep 1, 2024 Accepting new patients
Downriver Mental Health Clinic PC Clinical CurrentSince Aug 23, 2024 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

142 E Maumee St
Ste 3
Adrian, MI 49221
Phone (517) 263-5810

2350 Green Rd
Ste 160
Ann Arbor, MI 48105
Phone (315) 771-4657

2350 Green Rd
Ste 150160
Ann Arbor, MI 48105
Phone (734) 285-8282

20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282

Organizations & group practices 3

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": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783123200000",
    "number": "1104376250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W RUSSELL ST",
            "city": "SALINE",
            "state": "MI",
            "postal_code": "481761183",
            "telephone_number": "734-429-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W RUSSELL ST",
            "city": "SALINE",
            "state": "MI",
            "postal_code": "481761183",
            "telephone_number": "734-429-1660",
            "fax_number": "734-429-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEHM",
        "first_name": "SHANNON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2026-07-04",
        "certification_date": "2026-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801118677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saline, MI

Sources for this page

Verify at the official NPI Registry.