Individual provider Active NPI

Shannon Joy Heick, LCSW

  • Clinical Social Worker
  • Fargo, ND
National Provider Identifier
1154726057
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3763 Issued in ND
Practice address
1112 Nodak Dr S
Fargo, ND 58103-2333
Phone
(701) 232-6224
Fax
(701) 232-4687
NPI assigned
Nov 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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 3763 ND Primary

Addresses

Primary practice location

1112 Nodak Dr S
Fargo, ND 58103-2333

Mailing address

509 25TH Ave N
Fargo, ND 58102-1938
Phone (701) 232-6224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20201113002185 ND Practitioner - Clinical Social Worker 7911317383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of North Dakota School of Medicine, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Valley Christian Counseling Center IncGroup PAC ID 6709845654, 19 clinicians

Practice addresses (Care Compare)

1112 Nodak Dr S
Fargo, ND 58103-2333
Phone (701) 232-6224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Christian Counseling Center Inc Clinical CurrentSince Nov 1, 2020 Accepting new patients

Locations

1112 Nodak Dr S
Fargo, ND 58103
Phone (701) 232-6224

509 25th Ave N
Fargo, ND 58102
Phone (701) 232-6224

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1154726057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 25TH AVE N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581021938",
            "telephone_number": "701-232-6224",
            "fax_number": "701-232-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 NODAK DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032333",
            "telephone_number": "701-232-6224",
            "fax_number": "701-232-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEICK",
        "first_name": "SHANNON",
        "middle_name": "JOY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-04",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "3763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.