Individual provider Active NPI

Roxann Adrian Shook, LPC

  • Mental Health Counselor
  • Cheyenne, WY
National Provider Identifier
1144843806
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPC.0019869 Issued in CO
Practice address
4915 Nimmo Dr
Cheyenne, WY 82009-4808
Phone
(307) 331-8993
NPI assigned
May 28, 2020
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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 LPC.0019869 CO Primary

Addresses

Primary practice location

4915 Nimmo Dr
Cheyenne, WY 82009-4808

Mailing address

4915 Nimmo Dr
Cheyenne, WY 82009-4808
Phone (307) 331-8993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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
I20240510002672 WY Practitioner - Mental Health Counselor 6204277031 Practice locations: Cheyenne, WY

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4915 Nimmo Dr
Cheyenne, WY 82009-4808
Phone (970) 658-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC.0019869COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hiraeth Therapy, LLC Mental Health CurrentSince Dec 3, 2023 Accepting new patients

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": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1144843806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 NIMMO DR",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094808",
            "telephone_number": "307-331-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 NIMMO DR",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820094808",
            "telephone_number": "307-331-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOK",
        "first_name": "ROXANN",
        "middle_name": "ADRIAN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-28",
        "last_updated": "2023-11-29",
        "certification_date": "2021-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0019869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

Verify at the official NPI Registry.