Kathleen Marie Shannon, LISW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

I.0003968-SUPV Issued in OH

Practice address

930 Trailwood Dr
Boardman, OH 44512-5007

Phone

(513) 834-7063

Fax

(513) 873-1567

NPI assigned

Sep 22, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Clinical Social Worker

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Aspire Mental Health LLCGroup PAC ID 7315323987, 20 clinicians

Rajendra P Koirala, M.D., LLCGroup PAC ID 8820334931, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/parkmanrecovery/r4/

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.

• Aspire Mental Health LLC

  • Community/Behavioral Health Agency
  • East Liverpool, OH
  • NPI 1043946254
  Medicare reassignment Care Compare group NPD
• Rajendra P Koirala, M.D., LLC

  • Psychiatry Physician
  • Youngstown, OH
  • NPI 1760977177
  Medicare reassignment Care Compare group
• Columbiana County Mental Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lisbon, OH
  • NPI 1508827932
  Medicare reassignment NPD
• Family & Community Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Warren, OH
  • NPI 1750607057
  Medicare reassignment NPD
• Coleman Professional Services, Inc.

  • Mental Health Counselor
  • Kent, OH
  • NPI 1982637633
  Medicare reassignment
• Family & Community Services, Inc

  • Addiction (Substance Use Disorder) Counselor
  • Kent, OH
  • NPI 1952662108
  NPD
• Compass Family and Community Services

  • Community/Behavioral Health Agency
  • Warren, OH
  • NPI 1083054506
  NPD (past)
• Compass Family and Community Services

  • Community/Behavioral Health Agency
  • Youngstown, OH
  • NPI 1699742239
  NPD (past)
• FSR of Parkman LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Warren, OH
  • NPI 1487168084
  NPD (past)
• Rajendra P Koirala, M.D., LLC

  • Family Medicine Physician
  • Youngstown, OH
  • NPI 1265142830
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1225137219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 ELSINORE PL STE 200",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452021459",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 TRAILWOOD DR",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445125007",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4930 Enterprise Dr NW",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444818706",
            "country_code": "US",
            "telephone_number": "330-787-0955 x136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.0003968-SUPV",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I0003968",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Shaffer, CDCA
• Lawrence A Shaffer, M.D.
• Teresa Marie Shaffer, CNP
• Kruti Munir Shah, MD
• Muhammad Usman Shaikh, M.D.
• Patrick L. Shannon, M.D.
• Norhan Sharaf, DO
• Abhay Sharma, MD
• Shivani Sharma, M.D.
• Sharpe Builders LLC

• Social Worker in Boardman, OH
• Providers in Boardman, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.