Individual provider Active NPI

Shannon Andrews, LCSW

  • Clinical Social Worker
  • Hayden, ID
National Provider Identifier
1477009041
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-36039 Issued in ID
Practice address
9494 N Government Way # 103
Hayden, ID 83835-9848
Phone
(208) 967-6895
Fax
(208) 277-0766
NPI assigned
Sep 1, 2016
Last updated
Oct 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X LCSW-36039 ID Primary

Addresses

Primary practice location

9494 N Government Way # 103
Hayden, ID 83835-9848

Mailing address

PO Box 1575
Post Falls, ID 83877-1575
Phone (208) 967-6895

Other identifiers 2

IdentifierTypeStateIssuer
8139486-3501OtherUTUTAH LICENSE
LCSW-36039OtherIDPROFESSIONAL STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20161004002253 ID Practitioner - Clinical Social Worker 7911295175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9494 N Government Way
Hayden, ID 83835-9848
Phone (208) 967-6895

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spirit Counseling Services PLLC Clinical CurrentSince Feb 1, 2020 Accepting new patients

Locations

1250 W Ironwood Dr
Ste 335
Coeur D Alene, ID 83814
Phone (208) 667-1174

9494 N Government Way
#103
Hayden, ID 83835
Phone (208) 967-6895

9494 N Government Way
Ste 103
Hayden, ID 83835

1224 N Idaho St
Ste 6
Post Falls, ID 83854

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

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1477009041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1575",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838771575",
            "telephone_number": "208-967-6895",
            "fax_number": "208-277-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9494 N GOVERNMENT WAY # 103",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838359848",
            "telephone_number": "208-967-6895",
            "fax_number": "208-277-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "SHANNON",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-36039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTAH LICENSE",
            "identifier": "8139486-3501",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL STATE LICENSE",
            "identifier": "LCSW-36039",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayden, ID

Sources for this page

Verify at the official NPI Registry.