Shyanna Kirby, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.026648 Issued in IL

Practice address

1400 Eberhart Ave
Edwardsville, IL 62025-1013

Phone

(217) 871-1089

NPI assigned

Jul 20, 2021

Last updated

Jul 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Shyanna Vanmeter Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Soulful Spaces Therapy PLLC

  • Clinical Social Worker
  • Edwardsville, IL
  • NPI 1255174447
  NPD Authorized official
• Counselors Associates

  • Professional Counselor
  • Maryville, IL
  • NPI 1922399682
  NPD
• New Leaf Counseling Services, LLC

  • Community/Behavioral Health Agency
  • Glen Carbon, IL
  • NPI 1104101732
  NPD (past)

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1477126340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 EBERHART AVE",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251013",
            "telephone_number": "217-871-1089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 EBERHART AVE",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251013",
            "telephone_number": "217-871-1089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Oak Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "IL",
            "postal_code": "620625635",
            "country_code": "US",
            "telephone_number": "618-972-1568",
            "fax_number": "618-205-3561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2615 Edwards St",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620023915",
            "country_code": "US",
            "telephone_number": "618-462-2331",
            "fax_number": "618-462-2504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRBY",
        "first_name": "SHYANNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150105411",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.026648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHYANNA",
            "last_name": "VANMETER",
            "credential": "LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kevin Treloar Ma MSW LCSW
• Kid Glasses, Inc.
• Amy N Kief, RN
• Mary T Kimutis, RN
• Adrienne Beth Kinney, NP
• Brennan Klaassen, BSN, RN
• Steven Kleffner
• Jenna Suzanne Kleiboeker, BEHAVIOR TECHNICIAN
• Jamie Klingler
• Karli Koen

• Clinical Social Worker in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.