Active NPI
Shannon Nicole Lenze, PHD
- Clinical Psychologist
- Saint Louis, MO
National Provider Identifier
1447553441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2008016949
- Practice address
- 600 S Taylor Ave
Dept Psychiatry, Ste 122
Saint Louis, MO 63110-1035 - Phone
- (314) 286-1700
- Fax
- (314) 970-9094
- NPI assigned
- Dec 13, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2008016949 | MO | Primary |
Addresses
Primary practice location
600 S Taylor Ave
Dept Psychiatry, Ste 122
Saint Louis, MO 63110-1035
Mailing address
PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 286-1700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 494217409 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2008016949 | MO | MD | Clinical Psychologist |
Interoperability endpoints
- slenze157627@direct.carenet.org
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Saint Louis, MO
- NPI 1003856592
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744848000000",
"number": "1447553441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7412011",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606742011",
"telephone_number": "314-286-1700",
"fax_number": "314-970-9094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 S TAYLOR AVE",
"address_2": "DEPT PSYCHIATRY, STE 122",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631101035",
"telephone_number": "314-286-1700",
"fax_number": "314-970-9094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LENZE",
"first_name": "SHANNON",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-13",
"last_updated": "2025-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "2008016949",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "494217409",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Washington University",
"address_1": "600 S Taylor Ave",
"address_2": "Dept Psychiatry, Ste 122",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631101035",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.