Shannon G O'Brien, MSW, LCSW, CSAC,CTS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7197-123 Issued in WI

Practice address

2821 N. 4TH Street
Suite 139
Milwaukee, WI 53212

Phone

(414) 264-4217

Fax

(414) 264-4218

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Clinical Social Worker

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Professional Services Group Inc.Group PAC ID 8224296454, 22 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Professional Services Group, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kenosha, WI
  • NPI 1619024262

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD
• Affiliated Surgery Center Inc

  • Ambulatory Surgical Clinic/Center
  • Milwaukee, WI
  • NPI 1154795649
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299456000000",
    "number": "1366529182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 N 4TH ST",
            "address_2": "SUITE 139",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122362",
            "telephone_number": "414-264-4217",
            "fax_number": "414-264-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 N. 4TH STREET",
            "address_2": "SUITE 139",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53212",
            "telephone_number": "414-264-4217",
            "fax_number": "414-264-4218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "SHANNON",
        "middle_name": "G",
        "credential": "MSW, LCSW, CSAC,CTS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "1971-132",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7197-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39397100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica L O'Brien, MD
• Katelyn Ann O'Brien, RD
• Kathryn O'Brien
• Kevin P O'Brien, LCSW, LMFT
• Marina O'Brien, PA-C
• Tierney Callahan O'Brien, MA, SSP
• Vanessa A. O'Brien, PT
• William Joseph O'Brien, DDS
• Lisa O'Connell, M.S. CCC-SLP
• Megan O'Connell, M.D.

• Clinical Social Worker in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.