Shannon Marie Wilson, LMHC, CRC, CADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

001593 Issued in IA

Practice address

1570 42ND St NE Ste 2a
Cedar Rapids, IA 52402-3073

Phone

(319) 430-1211

NPI assigned

Jun 21, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 1, 2024 through Feb 1, 2028

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• CBT Specialty Services of Iowa, LLC

  • Mental Health Counselor
  • Hiawatha, IA
  • NPI 1750950739
  NPD (past)
• Murray, Wilson & Rose Counseling and Behavioral Services

  • Mental Health Counselor
  • Hiawatha, IA
  • NPI 1710310644
  NPD (past)

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1629417746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 42ND ST NE STE 2A",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 42ND ST NE STE 2A",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023073",
            "telephone_number": "319-430-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LMHC, CRC, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-21",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Lynn Wilson, ARNP
• Audrey Erin Wilson
• Emily Marie Wilson, MOTR/L
• Jordan Wilson
• Karen Camille Wilson, DDS
• Stephanie Wilson, DNP
• Timothy Van Winegarden, DDS, MSD
• Jamie Wingert, MA, LMHCT
• Winslow Clinic PLLC
• Christine M Winter-Rundell, O.D., FCOVD

• Mental Health Counselor in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.