Shannon Vavrusa, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.028640 Issued in IL

Practice address

311 W Depot St
Antioch, IL 60002-1500

Phone

(331) 725-1190

NPI assigned

Jan 22, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• New Leaf Counseling

  • Clinical Social Worker
  • Antioch, IL
  • NPI 1902381593
  NPD (past)

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

{
    "created_epoch": "1737504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1285446708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W145 LILAC AVE",
            "city": "GENOA CITY",
            "state": "WI",
            "postal_code": "531281986",
            "telephone_number": "847-217-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W DEPOT ST",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021500",
            "telephone_number": "331-725-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAVRUSA",
        "first_name": "SHANNON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-22",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.028640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trust & Transform Counseling, PLLC
• Taylor Loreen Turman
• Jeffery Turnbull, D.C.
• Jessica Urban, LCSW
• Diana Vasquez-Alcala, LCSW
• Kimberly Vepley
• Viezjo LLC
• Village of Antioch
• Robin Vlosky, MS, ED.S., LPC, NCSP
• Elizabeth Vogt, LCSW, CADC

• Clinical Social Worker in Antioch, IL
• Providers in Antioch, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.