Shannon Marie Bolick

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

PO Box 1823
Manitowoc, WI 54221-1823

Phone

(920) 663-1035

NPI assigned

Jan 3, 2025

Last updated

Jan 3, 2025By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Mental Health Counselor

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Core Treatment Services, Inc.Group PAC ID 6608267430, 7 clinicians

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

• Core Treatment Services, Inc.

  • Community/Behavioral Health Agency
  • Manitowoc, WI
  • NPI 1659912319
  Care Compare group NPD
• Core Treatment Services, Inc.

  • Professional Counselor
  • Manitowoc, WI
  • NPI 1982491882
  NPD

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

{
    "created_epoch": "1735862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1437968583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1823",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542211823",
            "telephone_number": "920-663-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 1823",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542211823",
            "telephone_number": "920-663-1035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLICK",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-03",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Bishop
• Sheana Blackmon
• Blue Waters Family Counseling, S.C.
• Daniel R Boettcher, DDS
• Julia A Boldt, PTA
• Lori A Bonin, PT
• Michael Bonin
• Nicole Bonin, MSW, LCSW
• Abram Richard Bonneville, PA-S
• Brian L Boomgarden, MS CADC

• Mental Health Counselor in Manitowoc, WI
• Providers in Manitowoc, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; 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.