Shannon L Spicer, LMSW, CAADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801113543 Issued in MI

Practice address

2424 W Washington Ave
Jackson, MI 49203-1236

Phone

(517) 205-6788

NPI assigned

Jan 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shannon L Douglas Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Family Service and Childrens Aid

  • Community/Behavioral Health Agency
  • Jackson, MI
  • NPI 1699861609
  Medicare reassignment NPD
• W. a. Foote Memorial Hospital, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jackson, MI
  • NPI 1326078866

  Clinical

  Medicare reassignment NPD
• W.a. Foote Memorial Hospital, Inc

  • Social Worker
  • Jackson, MI
  • NPI 1134666092

  Clinical

  NPD
• W.a. Foote Memorial Hospital, Inc

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1225545650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 W WASHINGTON AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492031236",
            "telephone_number": "517-205-6788",
            "fax_number": "517-787-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 W WASHINGTON AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492031236",
            "telephone_number": "517-205-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPICER",
        "first_name": "SHANNON",
        "middle_name": "L",
        "credential": "LMSW, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-08",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801113543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "DOUGLAS",
            "middle_name": "L",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kay Spencer, RN
• Miranda Kaye Spencer
• Shawni Spencer, RDH
• Joshua Robert Spicer, DO
• Megan Kyna Spicer, N.P.
• Craig Eugene Sponseller, PA-C
• Gregory James Spray, CCC-SLP
• Spring Arbor Dental PLLC
• Springcrest Family Physicians, P.C.
• Springcrest Sleep Solutions PLLC

• Clinical Social Worker in Jackson, MI
• Providers in Jackson, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.