Shannon M Poe, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.025909 Issued in IL

Practice address

2654 N Central Park Ave
Chicago, IL 60647-1102

Phone

(504) 952-4762

NPI assigned

Jul 16, 2014

Last updated

Sep 25, 2023By 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

Other names 1

• Dr. Shannon M Barr Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dr Shannon Poe LCSW DSW PLLC

  • Adult Mental Health Clinic/Center
  • Springfield, IL
  • NPI 1831084102
  NPD Authorized official

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1518374180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2654 N CENTRAL PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471102",
            "telephone_number": "504-952-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2654 N CENTRAL PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471102",
            "telephone_number": "504-952-4762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5547 N Ravenswood Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606401125",
            "country_code": "US",
            "telephone_number": "773-234-6554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POE",
        "first_name": "SHANNON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-16",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "12624",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.025909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "BARR",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "LSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jessica Podraza, LPC
• Ronald Alexander Podraza, DDS
• Korie Poe, LCPC, NCC
• Lisa G Poe, LCSW
• Ryan Caitlin Poe
• Jenifer Ann Poell, CNM, WHNP-BC, MSN
• Kristine Elizabeth Poelsterl, MBA, RDN, LDN
• Alyssa Poentis, MD
• Elizabeth Poetzing, LCPC
• Charles Poff

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, 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 Sep 25, 2023; 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.