Shannon Jean Maxwell, PSY.D, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

530 Issued in SD

Practice address

115 N 7TH St Ste 6
Spearfish, SD 57783-2710

Phone

(605) 645-0100

Fax

(605) 717-1009

NPI assigned

Feb 16, 2012

Last updated

Jan 20, 2026By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SD

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 Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Black Hills Psychology LLCGroup PAC ID 4587852009, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Black Hills Psychology, LLC

  • Clinical Psychologist
  • Spearfish, SD
  • NPI 1811290992
  Medicare reassignment Care Compare group Authorized official
• Scovel Psychological and Counseling Services, LTD

  • Psychologist
  • Rapid City, SD
  • NPI 1578744504
  Medicare reassignment NPD
• Bahr Chiropractic Wellness Center LLC

  • Chiropractor
  • Rapid City, SD
  • NPI 1093941049
  NPD (past)

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1790058089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N 7TH ST STE 6",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577832710",
            "telephone_number": "605-645-0100",
            "fax_number": "605-717-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N 7TH ST STE 6",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577832710",
            "telephone_number": "605-645-0100",
            "fax_number": "605-717-1009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 W Main St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Rapid City",
            "state": "SD",
            "postal_code": "577022439",
            "country_code": "US",
            "telephone_number": "605-645-0100",
            "fax_number": "605-717-1009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "SHANNON",
        "middle_name": "JEAN",
        "credential": "PSY.D, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-16",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SD",
            "license": "530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2009373",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• McKenzie Marta
• Matson Therapy, LLC (Black Hills Physical Therapy)
• Jens K Matson, PT. DPT, OCS, CMPT
• Maria Matson, PT, DPT
• Scott R Matthew, CRNA
• David George May
• Mary McAdoo
• Maryclaire McGreevy
• Robert McIntosh, D.C.
• Ruth M. McLaughlin, M.D.

• Clinical Psychologist in Spearfish, SD
• Providers in Spearfish, SD by specialty
• Clinical Psychologist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; 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.