Individual provider Active NPI

Vanessa Ann Shuck, MSW, LGSW

  • Social Worker
  • Shoreview, MN
National Provider Identifier
1306604673
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
31224 Issued in MN
Practice address
3490 Lexington Ave N Ste 205
Shoreview, MN 55126-8044
Phone
(651) 486-3808
NPI assigned
Mar 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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 31224 MN Primary

Addresses

Primary practice location

3490 Lexington Ave N Ste 205
Shoreview, MN 55126-8044

Mailing address

3490 Lexington Ave N Ste 205
Shoreview, MN 55126-8044
Phone (651) 486-3808

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20260130000708 MN Practitioner - Clinical Social Worker 3779061882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3490 Lexington Ave N
Suite 205
Shoreview, MN 55126-8044

7525 Mitchell Rd
Suite 215
Eden Prairie, MN 55344-1957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31224MNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Youth & Family Services CurrentSince Dec 21, 2025 Accepting new patients
Northeast Youth & Family Services PastSince Mar 17, 2024 Accepting new patients

Locations

3490 Lexington Ave N
Ste 205
Shoreview, MN 55126
Phone (651) 486-3808

Organizations & group practices 2

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": "1710115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1306604673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3490 LEXINGTON AVE N STE 205",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268044",
            "telephone_number": "651-486-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3490 LEXINGTON AVE N STE 205",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268044",
            "telephone_number": "651-486-3808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUCK",
        "first_name": "VANESSA",
        "middle_name": "ANN",
        "credential": "MSW, LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "31224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreview, MN

Sources for this page

Verify at the official NPI Registry.