Shanna Severn, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

8855 SW Holly LN
Suite 126
Wilsonville, OR 97070-8854

Phone

(971) 264-4505

NPI assigned

May 5, 2014

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

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.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1700296266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30150 SW PARKWAY AVE STE 300",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970706836",
            "telephone_number": "971-264-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8855 SW HOLLY LN",
            "address_2": "SUITE 126",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970708854",
            "telephone_number": "971-264-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERN",
        "first_name": "SHANNA",
        "credential": "NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-05",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Scott, LMT
• Michael M Seale, M.D.
• Elizabeth C Sedlak, N.D.
• Megan Elizabeth Seeley, PTA
• Serenity Dental, LLC
• Jay Ajit Shah, MD
• Michelle Shannon
• Marlene Shapiro, CCC/SLP
• Sarah Elizabeth Sharp, COTA
• Richard Scott Shaw, D.MFT

• Mental Health Counselor in Wilsonville, OR
• Providers in Wilsonville, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.