Individual provider Active NPI

Shannon L Erickson, LCSW

  • Clinical Social Worker
  • New Port Richey, FL
National Provider Identifier
1760403323
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW5729 Issued in FL
Practice address
8022 Old County Road 54
New Port Richey, FL 34653-6409
Phone
(727) 641-7941
Fax
(727) 287-9302
NPI assigned
Jul 21, 2006
Last updated
Oct 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW5729 FL Primary

Addresses

Primary practice location

8022 Old County Road 54
New Port Richey, FL 34653-6409

Mailing address

8022 Old County Road 54
New Port Richey, FL 34653-6409
Phone (727) 641-7941

Other identifiers 1

IdentifierTypeStateIssuer
761762300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20131108000692 FL Practitioner - Clinical Social Worker 7517192040 Practice locations: New Port Richey, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8022 Old County Rd
Suite 54
New Port Richey, FL 34653-6409
Phone (727) 784-8244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Outcomes Counseling Clinical PastSince Oct 23, 2022 Accepting new patients
Caring Counseling LLC PastSince Oct 23, 2022 Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1760403323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8022 OLD COUNTY ROAD 54",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346536409",
            "telephone_number": "727-641-7941",
            "fax_number": "727-287-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8022 OLD COUNTY ROAD 54",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346536409",
            "telephone_number": "727-641-7941",
            "fax_number": "727-287-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "SHANNON",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "761762300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

Verify at the official NPI Registry.