Individual provider Active NPI

Lauri A. Shannon, LCSW

  • Clinical Social Worker
  • Palm Harbor, FL
National Provider Identifier
1366818510
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12717 Issued in FL
Practice address
34931 US Highway 19 N Ste 116117
Palm Harbor, FL 34684-1913
Phone
(786) 423-6787
Fax
(844) 556-4651
NPI assigned
Aug 11, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW12717 FL Primary

Addresses

Primary practice location

34931 US Highway 19 N Ste 116117
Palm Harbor, FL 34684-1913

Mailing address

34931 US Highway 19 N Ste 116
Palm Harbor, FL 34684-1923
Phone (786) 423-6787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160803003221 FL Practitioner - Clinical Social Worker 4082915509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

34931 US Hwy 19 N
Suite 117
Palm Harbor, FL 34684-1901
Phone (786) 423-6787

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW12717FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Las Counseling, LLC CurrentSince Apr 16, 2016 Accepting new patients

Locations

2999 NE 191st St
Miami, FL 33180
Phone (305) 682-1795

34931 US Highway 19 N
Ste 117
Palm Harbor, FL 34684
Phone (786) 423-6787

34931 US Highway 19 N
Ste 116
Palm Harbor, FL 34684

34931 US Highway 19 N
Ste 116117
Palm Harbor, FL 34684
Phone (786) 423-6787

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": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1366818510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34931 US HIGHWAY 19 N STE 116",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346841923",
            "telephone_number": "786-423-6787",
            "fax_number": "844-556-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34931 US HIGHWAY 19 N STE 116117",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346841913",
            "telephone_number": "786-423-6787",
            "fax_number": "844-556-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "LAURI",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

Verify at the official NPI Registry.