Individual provider Active NPI

Shannon Marie Seibel, MS

  • Mental Health Counselor
  • Laporte, MN
National Provider Identifier
1396488474
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
25958 474TH St
Laporte, MN 56461-4870
Phone
(218) 407-0596
NPI assigned
Apr 18, 2022
Last updated
Apr 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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 MN Primary

Addresses

Primary practice location

25958 474TH St
Laporte, MN 56461-4870

Mailing address

25958 474TH St
Laporte, MN 56461-4870
Phone (218) 407-0596

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
I20250102000133 MN Practitioner - Mental Health Counselor 8224565320 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Health of Northern Minnesota CurrentSince Dec 2, 2024 Accepting new patients
Sanford Health of Northern Minnesota Current Accepting new patients
Sanford Health of Northern Minnesota CurrentSince Dec 2, 2024 Accepting new patients

Locations

1611 Anne St NW
Bemidji, MN 56601
Phone (218) 333-2020

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1396488474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25958 474TH ST",
            "city": "LAPORTE",
            "state": "MN",
            "postal_code": "564614870",
            "telephone_number": "218-407-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25958 474TH ST",
            "city": "LAPORTE",
            "state": "MN",
            "postal_code": "564614870",
            "telephone_number": "218-407-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIBEL",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laporte, MN

Sources for this page

Verify at the official NPI Registry.