Individual provider Active NPI

Shannon Watson, LCSW

Social Worker
Terrytown, LA

National Provider Identifier

1417555129

Registry record updated Feb 2, 2021

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Organizations & group practices1
NPI Registry JSON
Other providers in Terrytown, LA
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Social WorkerTaxonomy code 104100000X
License: 7511 Issued in LA
Practice address: 613 National Ave
Terrytown, LA 70056-2907
Phone: (504) 606-7416
NPI assigned: Oct 14, 2020
Sex: Female
Sole proprietor: Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 14

Specialty (taxonomy)	Code	License	State	Primary
Counselor	101Y00000X	7511	LA
School Social Worker	1041S0200X	7511	LA
Addiction (Substance Use Disorder) Counselor	101YA0400X	7511	LA
Mental Health Counselor	101YM0800X	7511	LA
Professional Counselor	101YP2500X	7511	LA
Psychoanalyst	102L00000X	7511	LA
Behavior Analyst	103K00000X	7511	LA
Marriage & Family Therapist	106H00000X	7511	LA
Behavior Technician	106S00000X	7511	LA
Military Health Care Provider	171000000X	7511	LA
Case Manager/Care Coordinator	171M00000X	7511	LA
Health Educator	174H00000X	7511	LA
Mental Health Clinic/Center (Including Community Mental Health Center)	261QM0801X	7511	LA
Social Worker	104100000X	7511	LA	Primary

Addresses

Primary practice location

613 National Ave
Terrytown, LA 70056-2907

Mailing address

613 National Ave
Terrytown, LA 70056-2907
Phone (504) 606-7416

Electronic endpoints 1

Type	Endpoint	Use	Affiliation
Other URL	COX	Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment

Enrolled in LA

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 ID	State	Provider type	PAC ID	Details
I20210323000693	LA	Practitioner - Clinical Social Worker	5395152177

National Provider Directory

Medicare enrollment (NPD): Enrolled

State licenses

License	State	Type	Specialty
7511	LA	MD	Case Manager/Care Coordinator

Practice roles

Organization	Specialty	Status	New patients
S Watson Counseling Services, LLC	Mental Health	CurrentSince Dec 18, 2020	Accepting new patients

Locations

701 Papworth Ave
Ste 208
Metairie, LA 70005
Phone (504) 913-8104

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

S Watson Counseling Services, LLC
- Mental Health Counselor
- Terrytown, LA
- NPI 1770170375
NPD Authorized official

NPI Registry JSON

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1417555129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 NATIONAL AVE",
            "city": "TERRYTOWN",
            "state": "LA",
            "postal_code": "700562907",
            "telephone_number": "504-606-7416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 NATIONAL AVE",
            "city": "TERRYTOWN",
            "state": "LA",
            "postal_code": "700562907",
            "telephone_number": "504-606-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "SHANNON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-14",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "LA",
            "license": "7511",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "LA",
            "license": "7511",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": "7511",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "7511",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "7511",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "LA",
            "license": "7511",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "LA",
            "license": "7511",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "LA",
            "license": "7511",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "LA",
            "license": "7511",
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "LA",
            "license": "7511",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "LA",
            "license": "7511",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "LA",
            "license": "7511",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "LA",
            "license": "7511",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "7511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "COX",
            "affiliation": "N",
            "endpointDescription": "Cable",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "613 National Ave",
            "city": "Terrytown",
            "state": "LA",
            "country_code": "US",
            "postal_code": "700562907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Terrytown, LA

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.