Active NPI
Shannon Roosma, LPC
- Professional Counselor
- Salem, VA
National Provider Identifier
1225655848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0701008223
- Practice address
- 2212 Mulberry St
Salem, VA 24153-6013 - Phone
- (434) 665-1800
- NPI assigned
- Jun 30, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0701008223 | VA | Primary |
Addresses
Primary practice location
2212 Mulberry St
Salem, VA 24153-6013
Mailing address
2212 Mulberry St
Salem, VA 24153-6013
Phone (434) 665-1800
Other names 1
- Shannon Kinzie
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3235 Electric Rd
Suite 1a
Roanoke, VA 24018-6404
Phone (855) 284-7483
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Counseling LLC | Single Specialty | Current | Accepting new patients |
Locations
5310 Markel Rd
Ste 102
Richmond, VA 23230
Phone (804) 312-5498
3235 Electric Rd
Ste 1A
Roanoke, VA 24018
Phone (540) 210-1379
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": "1593475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593475200000",
"number": "1225655848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2212 MULBERRY ST",
"city": "SALEM",
"state": "VA",
"postal_code": "241536013",
"telephone_number": "434-665-1800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2212 MULBERRY ST",
"city": "SALEM",
"state": "VA",
"postal_code": "241536013",
"telephone_number": "434-665-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOSMA",
"first_name": "SHANNON",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-30",
"last_updated": "2020-06-30",
"certification_date": "2020-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "VA",
"license": "0701008223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHANNON",
"last_name": "KINZIE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Salem, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.