Shannon Nickerson, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

111 Church St
Laconia, NH 03246-3432

Phone

(603) 524-1100

NPI assigned

Jul 5, 2016

Last updated

Jul 5, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NH

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Care Counseling Services LLCGroup PAC ID 0244630473, 2 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Care Counseling Services LLC

  • Mental Health Counselor
  • Manchester, NH
  • NPI 1205344462

  Clinical

  Medicare reassignment Care Compare group NPD
• Care Institute of New England

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Manchester, NH
  • NPI 1356071021
  NPD
• Healthfirst Family Care Center, Inc.

  dba Isaiah 61 Cafe

  • Federally Qualified Health Center (FQHC)
  • Laconia, NH
  • NPI 1972203347
  NPD (past)
• The Lakes Region Mental Health Center, Inc.

  dba Genesis Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Laconia, NH
  • NPI 1902994866
  NPD (past)

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467676800000",
    "number": "1437501319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CHURCH ST",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "032463432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CHURCH ST",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "032463432",
            "telephone_number": "603-524-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "SHANNON",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-05",
        "last_updated": "2016-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Eugene Neveln, BS
• Stephanie Neville, MD
• New Leaf Counseling (Birch Tree Counseling)
• Shelley Nichols
• Victoria Nichols, APRN, FNP
• Denise O'Brien, BA
• Kylie Francis O'Connell, BCBA
• Taylor O'Connor
• Stephanie O'Neal, LMT, PTA
• Alison O'Neill, MS, LCMHC

• Clinical Social Worker in Laconia, NH
• Providers in Laconia, NH by specialty
• Clinical Social Worker in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; 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.