Individual provider Active NPI

Shannon Lynn McPherson, LCSW

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1447853494
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1200 Issued in CO
Practice address
2864 S Circle Dr Ste 450
Colorado Springs, CO 80906-4170
Phone
(719) 776-8850
NPI assigned
Nov 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CSW.00001200 CO
Clinical Social Worker 1041C0700X 1200 CO Primary

Addresses

Primary practice location

2864 S Circle Dr Ste 450
Colorado Springs, CO 80906-4170

Mailing address

634 S Rogers Dr
Pueblo West, CO 81007-2773
Phone (719) 252-8603

Other practice location 1

729 E Spaulding Ave
Pueblo West, CO 81007-3512
Phone (719) 547-9119

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Centura.org Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231213001873 CO Practitioner - Mental Health Counselor 9830548015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

729 E Spaulding Ave
PRPW PC Pueblo West
Pueblo West, CO 81007-3512
Phone (719) 547-9119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1200COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Health Initiatives Colorado Current Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jan 1, 2024 Accepting new patients
Catholic Health Initiatives Colorado CurrentSince Jan 1, 2024 Accepting new patients
Senior & Family Consultants Clinical PastSince Nov 22, 2020 Accepting new patients

Locations

9100 E Mineral Cir
Centennial, CO 80112
Phone (303) 561-5193

2864 S Circle Dr
Ste 450
Colorado Springs, CO 80906
Phone (719) 776-8850

729 E Spaulding Ave
Pueblo West, CO 81007
Phone (719) 285-2735

41 State Highway 67
Woodland Park, CO 80863
Phone (719) 686-0551

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1447853494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 S ROGERS DR",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810072773",
            "telephone_number": "719-252-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2864 S CIRCLE DR STE 450",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809064170",
            "telephone_number": "719-776-8850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "729 E Spaulding Ave",
            "address_purpose": "LOCATION",
            "city": "Pueblo West",
            "state": "CO",
            "postal_code": "810073512",
            "country_code": "US",
            "telephone_number": "719-547-9119",
            "fax_number": "719-547-7555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCPHERSON",
        "first_name": "SHANNON",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-20",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CO",
            "license": "CSW.00001200",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "1200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Centura.org",
            "affiliation": "N",
            "endpointDescription": "health care",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2864 S Circle Dr Ste 450",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809064170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.