Individual provider Active NPI

Shane Alexander Hedrington, LPCC

  • Mental Health Counselor
  • Rochester, MN
National Provider Identifier
1326722513
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CC03855 Issued in MN
Practice address
343 Woodlake Dr SE
Rochester, MN 55904-6242
Phone
(507) 535-3484
NPI assigned
Jun 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CC03855 MN Primary

Addresses

Primary practice location

343 Woodlake Dr SE
Rochester, MN 55904-6242

Mailing address

343 Woodlake Dr SE
Rochester, MN 55904-6242
Phone (507) 535-3484

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
I20250225001525 MN Practitioner - Mental Health Counselor 2466814561 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CC03855MNMDMental Health Counselor

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": "1686268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1326722513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 WOODLAKE DR SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046242",
            "telephone_number": "507-535-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 WOODLAKE DR SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046242",
            "telephone_number": "507-535-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDRINGTON",
        "first_name": "SHANE",
        "middle_name": "ALEXANDER",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-09",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC03855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.