Individual provider Active NPI

Shannon Nicole Story, LPC

  • Mental Health Counselor
  • Lufkin, TX
National Provider Identifier
1578814554
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2001 S Medford Dr
Lufkin, TX 75901-6260
Phone
(936) 633-5676
Fax
(936) 633-5695
NPI assigned
Oct 1, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 67523 TX
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2001 S Medford Dr
Lufkin, TX 75901-6260

Mailing address

2001 S Medford Dr
Lufkin, TX 75901-6260
Phone (936) 633-5676

Other names 1

  • Shannon Nicole Beck Former name

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
I20241221000227 TX Practitioner - Mental Health Counselor 7315474889 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Burke Center CurrentSince Dec 1, 2024 Accepting new patients

Locations

2001 S Medford Dr
Lufkin, TX 75901
Phone (936) 633-5672

3824 N University Dr
Nacogdoches, TX 75965
Phone (936) 558-6200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1578814554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S MEDFORD DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759016260",
            "telephone_number": "936-633-5676",
            "fax_number": "936-633-5695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S MEDFORD DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759016260",
            "telephone_number": "936-633-5676",
            "fax_number": "936-633-5695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORY",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-01",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "67523",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "BECK",
            "middle_name": "NICOLE",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lufkin, TX

Sources for this page

Verify at the official NPI Registry.