Individual provider Active NPI

Shannon Kennedy Shiver, SOCIAL WORKER

  • Mental Health Counselor
  • Framingham, MA
National Provider Identifier
1790110849
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
848 Central St
Framingham, MA 01701-4815
Phone
(508) 879-5110
NPI assigned
Sep 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Mental Health Counselor 101YM0800X MA Primary

Addresses

Primary practice location

848 Central St
Framingham, MA 01701-4815

Mailing address

848 Central St
Framingham, MA 01701-4815

Other names 1

  • Shannon Margaret Kennedy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20231029000106 MD Practitioner - Clinical Social Worker 7618368739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Loyola University of Chicago, Stritch School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Heather L Hunt PHD LLCGroup PAC ID 6305835422, 5 clinicians

Practice addresses (Care Compare)

5 N Bentz St
Frederick, MD 21701-4913
Phone (240) 575-6210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61549TXMDProfessional Counselor
29181MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Heather L. Hunt, PH.D., LLC CurrentSince Sep 14, 2023 Accepting new patients

Locations

5 N Bentz St
Frederick, MD 21701
Phone (240) 575-6210

Organizations & group practices 1

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": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1790110849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 CENTRAL ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017014815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 CENTRAL ST",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017014815",
            "telephone_number": "508-879-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVER",
        "first_name": "SHANNON",
        "middle_name": "KENNEDY",
        "credential": "SOCIAL WORKER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-09",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "KENNEDY",
            "middle_name": "MARGARET",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Framingham, MA

Sources for this page

Verify at the official NPI Registry.