Individual provider Active NPI

Shannon Link, LCSW

  • Clinical Social Worker
  • Lafayette, CO
National Provider Identifier
1134610744
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09925438 Issued in CO
Practice address
1455 Dixon Ave
Lafayette, CO 80026
Phone
(303) 443-8500
NPI assigned
May 21, 2018
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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 09925438 CO Primary

Addresses

Primary practice location

1455 Dixon Ave
Lafayette, CO 80026

Mailing address

1786 34TH St NE
Sauk Rapids, MN 56379-4574
Phone (320) 267-4297

Other practice location 1

1106 17th St S
Sartell, MN 56377-2171
Phone (320) 267-4297

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
I20200630002763 MN Practitioner - Clinical Social Worker 0446673958 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09925438COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Jun 5, 2024 Accepting new patients
Centracare Health System - Sauk Centre CurrentSince Jun 1, 2020 Accepting new patients
Centracare Health System - Sauk Centre CurrentSince Jun 1, 2020 Accepting new patients
Centracare Health System - Sauk Centre Current Accepting new patients
Centracare Clinic Past Accepting new patients

Locations

1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342

2355 Highway 36 W
Ste 400
Saint Paul, MN 55113
Phone (612) 460-1597

425 Elm St N
Sauk Centre, MN 56378
Phone (320) 352-2221

Organizations & group practices 5

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": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1134610744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 34TH ST NE",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563794574",
            "telephone_number": "320-267-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 DIXON AVE",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "80026",
            "telephone_number": "303-443-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1106 17th St S",
            "address_purpose": "LOCATION",
            "city": "Sartell",
            "state": "MN",
            "postal_code": "563772171",
            "country_code": "US",
            "telephone_number": "320-267-4297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINK",
        "first_name": "SHANNON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-21",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09925438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

Verify at the official NPI Registry.