Individual provider Active NPI

Shannon Louise Dennis, LCSW

  • Clinical Social Worker
  • San Saba, TX
National Provider Identifier
1528115128
Registry record updated Jul 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11835 Issued in TX
Practice address
8535 FM 580
San Saba, TX 76877-8802
Phone
(512) 797-0632
NPI assigned
Jan 4, 2007
Last updated
Jul 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11835 TX Primary

Addresses

Primary practice location

8535 FM 580
San Saba, TX 76877-8802

Mailing address

8535 FM 580
San Saba, TX 76877-8802
Phone (512) 797-0632

Other identifiers 1

IdentifierTypeStateIssuer
0639262-01MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040312000881 TX Practitioner - Clinical Social Worker 8325937857 Reassigns benefits to 1 organization
Practice locations: San Saba, TX

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Austin Vitality CounselingGroup PAC ID 6406103928, 2 clinicians

Practice addresses (Care Compare)

12502 Palfrey Dr
Austin, TX 78727-3017
Phone (512) 422-4352

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11835TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Vitality Counseling Clinical CurrentSince Jan 28, 2020 Accepting new patients

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751760000000",
    "number": "1528115128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8535 FM 580",
            "city": "SAN SABA",
            "state": "TX",
            "postal_code": "768778802",
            "telephone_number": "512-797-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8535 FM 580",
            "city": "SAN SABA",
            "state": "TX",
            "postal_code": "768778802",
            "telephone_number": "512-797-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "SHANNON",
        "middle_name": "LOUISE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2025-07-06",
        "certification_date": "2025-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "11835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0639262-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Saba, TX

Sources for this page

Verify at the official NPI Registry.