Shannon M Bates, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L12986 Issued in OR

Practice address

Telehealth From Home
1857 Brookhurst St
Medford, OR 97504

Phone

(458) 206-4784

NPI assigned

Jan 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ah Addiction Care of California PC

  dba Anonymous Health

  • Addiction Medicine (Family Medicine) Physician
  • Sacramento, CA
  • NPI 1144055302
  NPD
• Ah Addiction Care PC

  dba Anonymous Health

  • Addiction Medicine (Family Medicine) Physician
  • Redwood City, CA
  • NPI 1295516128
  NPD

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1275007601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 TWIN DOLPHIN DRIVE",
            "address_2": "SUITE 600-6002",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "94065",
            "telephone_number": "844-542-5481",
            "fax_number": "877-237-0105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TELEHEALTH FROM HOME",
            "address_2": "1857 BROOKHURST ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "458-206-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATES",
        "first_name": "SHANNON",
        "middle_name": "M",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2024-05-20",
        "certification_date": "2020-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "ASW70857",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "93649",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L12986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Basilicato, NP
• Richard Paul Baska, MS, MFT
• Elizabeth Bastidas, LMT
• Eva Zhouying Batenhorst
• Kelly Bates, CRM
• Mindy Bath
• Hiilei Kelly Battistini, MA
• Annette T Batzer, NP
• Eden M Baucom
• Olivia Bauer, LAT, ATC

• Clinical Social Worker in Medford, OR
• Providers in Medford, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.