Individual provider Active NPI

Shannon McNabb, LCPC

  • Professional Counselor
  • Missoula, MT
National Provider Identifier
1689063000
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
BBH-LCPC-LIC-8346 Issued in MT
Practice address
900 N Orange St Ste 304
Missoula, MT 59802-2951
Phone
(406) 327-3362
Fax
(406) 327-3349
NPI assigned
Jan 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 74821 TX
Professional Counselor 101YP2500X BBH-LCPC-LIC-8346 MT Primary
Counselor 101Y00000X SWP-LCPC-LIC-8346 MT

Addresses

Primary practice location

900 N Orange St Ste 304
Missoula, MT 59802-2951

Mailing address

PO Box 12
Liberty Lake, WA 99019-0012
Phone (509) 824-1284

Other practice location 1

4520 Creekside Dr
Haltom City, TX 76137-2632
Phone (406) 249-6437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20240524002590 MT Practitioner - Mental Health Counselor 1254773088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

900 N Orange St
Missoula, MT 59802-2951
Phone (406) 327-3362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SWP-LCPC-LIC-8346MTMDCounselor
74821TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt CurrentSince May 6, 2024 Accepting new patients
Providence Health & Services Mt Current Accepting new patients
Providence Health & Services Mt CurrentSince May 6, 2024 Accepting new patients
United Minds LLC Current Accepting new patients

Locations

900 N Orange St
Ste 202
Missoula, MT 59802
Phone (406) 327-1670

900 N Orange St
Ste 304
Missoula, MT 59802
Phone (406) 329-5781

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

Organizations & group practices 4

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": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1689063000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190012",
            "telephone_number": "509-824-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N ORANGE ST STE 304",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598022951",
            "telephone_number": "406-327-3362",
            "fax_number": "406-327-3349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4520 Creekside Dr",
            "address_purpose": "LOCATION",
            "city": "Haltom City",
            "state": "TX",
            "postal_code": "761372632",
            "country_code": "US",
            "telephone_number": "406-249-6437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCNABB",
        "first_name": "SHANNON",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "74821",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "BBH-LCPC-LIC-8346",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MT",
            "license": "SWP-LCPC-LIC-8346",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.