Karin Shannon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

16941 N Eagle River Loop Rd
Eagle River, AK 99577-7824

Phone

(907) 406-7707

Fax

(907) 931-7248

NPI assigned

Aug 18, 2020

Last updated

Apr 4, 2024By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• A Safe Harbor Counseling Services

  • Clinical Social Worker
  • Eagle River, AK
  • NPI 1467204354
  NPD Authorized official

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1679185011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19332 WAR ADMIRAL RD",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995778482",
            "telephone_number": "417-793-2396",
            "fax_number": "907-931-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16941 N EAGLE RIVER LOOP RD",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777824",
            "telephone_number": "907-406-7707",
            "fax_number": "907-931-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "KARIN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AK",
            "license": "196321",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serendipity Care Services, LLC (BrightStar Care of Anchorage)
• Kristi Seymour, LPC
• Pamela Shackelford, BCBA
• Brittainy Birgit Shafer, MSN, RN
• Joseph M Shannon, LMT
• Rebecca Marie Shaw, PHD, LPC
• Timothy L Shaw, CRNA
• Jessalyn Nicole Sheaffer
• Camlynn Jean Shearer, MSN, APRN, AGPCNP-C
• Vanessa Sheets

• Clinical Social Worker in Eagle River, AK
• Providers in Eagle River, AK by specialty
• Clinical Social Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.