Shannon Eileen Mitchell, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60160440 Issued in WA

Practice address

2814 S Grand Blvd
Spokane, WA 99203-2528

Phone

(509) 863-6822

Fax

(509) 228-3116

NPI assigned

Dec 27, 2017

Last updated

Dec 20, 2018By 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 1

Addresses

Other identifiers 1

Other names 1

• Shannon Eileen Rouse Former name

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Clinical Social Worker

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Innovative Counseling Services LLC

  • Clinical Social Worker
  • Spokane, WA
  • NPI 1811468770
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1538675574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 E 45TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992236474",
            "telephone_number": "509-863-6822",
            "fax_number": "509-228-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 S GRAND BLVD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992032528",
            "telephone_number": "509-863-6822",
            "fax_number": "509-228-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SHANNON",
        "middle_name": "EILEEN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-27",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60160440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2114136",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "ROUSE",
            "middle_name": "EILEEN",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Mitchell
• Nathan Gregory Mitchell
• Nichole Jo Mitchell, CPC
• Rebecca Mitchell
• Robert Mitchell II, SUDP
• Thomas Taylor Mitchell, PH.D.
• Trevor Martin Mitchell
• Donika Olga Mithoug, R.N.
• John D Miura, PHARMD
• Cosette Razelle Mize, CBT

• Clinical Social Worker in Spokane, WA
• Providers in Spokane, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.