Shannon Booker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW.09926094 Issued in CO

Practice address

109 Coronado CT BLDG 7
Fort Collins, CO 80525-4929

Phone

(970) 795-8419

NPI assigned

Feb 15, 2021

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 CO

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Semita Nova Therapy, LLC

  • Clinical Social Worker
  • Severance, CO
  • NPI 1326710971
  Medicare reassignment NPD Authorized official
• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442
  Medicare reassignment NPD

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

{
    "created_epoch": "1613347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1437742012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5017 PRAIRIE LARK LN",
            "city": "SEVERANCE",
            "state": "CO",
            "postal_code": "806158105",
            "telephone_number": "970-988-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CORONADO CT BLDG 7",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805254929",
            "telephone_number": "970-795-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOKER",
        "first_name": "SHANNON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-15",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09926094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doucette Bondo
• Jessica Bondurant, BSN, RN
• Emily Bonham, RDN
• Kathryn Bonilla, MA
• Kristin Bonnesen, LPC
• Kendall M Boon
• Elise J Booth, FNP-C
• Richard Rawson Booth, M.D.
• Paige Cassidy Boran, CNM, APRN
• Lynn Borchers, PA-C

• Clinical Social Worker in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.