Individual provider Active NPI

Shannon Norma Nicholson, MSW

  • Social Worker
  • Danbury, CT
National Provider Identifier
1285042200
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
75 West St
Danbury, CT 06810-6528
Phone
(203) 721-4765
NPI assigned
Jul 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CT Primary

Addresses

Primary practice location

75 West St
Danbury, CT 06810-6528

Mailing address

44 Center St
Bristol, CT 06010-4915
Phone (843) 655-4022

Other names 1

  • Shannon Norma Bailey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20200824000877 CT Practitioner - Clinical Social Worker 4981020864 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2030 Straits Tpke
Suite 6
Middlebury, CT 06762-1831
Phone (843) 655-4022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New Beginnings Counseling LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

2030 Straits Tpke
Ste 6
Middlebury, CT 06762
Phone (203) 525-8558

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": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1285042200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 CENTER ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104915",
            "telephone_number": "843-655-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 WEST ST",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068106528",
            "telephone_number": "203-721-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "SHANNON",
        "middle_name": "NORMA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-23",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "BAILEY",
            "middle_name": "NORMA",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.