Individual provider Active NPI

Shannon Lee Royer, COUNSELOR

  • Mental Health Counselor
  • Champlin, MN
National Provider Identifier
1124608468
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
11141 Zealand Ave N
Champlin, MN 55316-3595
Phone
(763) 670-6050
NPI assigned
Apr 12, 2021
Last updated
Apr 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

11141 Zealand Ave N
Champlin, MN 55316-3595

Mailing address

11141 Zealand Ave N
Champlin, MN 55316-3595
Phone (763) 670-6050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Therapy Associates, PC CurrentSince Apr 20, 2021 Accepting new patients

Locations

11141 Zealand Ave N
Champlin, MN 55316
Phone (651) 653-0387

Organizations & group practices 1

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": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1124608468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11141 ZEALAND AVE N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163595",
            "telephone_number": "763-670-6050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11141 ZEALAND AVE N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163595",
            "telephone_number": "763-670-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYER",
        "first_name": "SHANNON",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "COUNSELOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champlin, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.