Shannon Leist, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34008294A Issued in IN

Practice address

2627 Charlestown Rd
New Albany, IN 47150-2536

Phone

(812) 944-1550

Fax

(812) 725-7865

NPI assigned

Dec 21, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shannon Waller Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Associates in Counseling and Psychotherapy

  • Clinical Psychologist
  • New Albany, IN
  • NPI 1801948062
  NPD (past)
• Associates in Counseling and Psychtherapy

  • Community/Behavioral Health Agency
  • New Albany, IN
  • NPI 1114330271
  NPD (past)

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1841655719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8006 VISTA PL",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471117733",
            "telephone_number": "812-777-5759",
            "fax_number": "812-725-7865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 CHARLESTOWN RD",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471502536",
            "telephone_number": "812-944-1550",
            "fax_number": "812-725-7865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8006 Vista Pl",
            "address_purpose": "LOCATION",
            "city": "Charlestown",
            "state": "IN",
            "postal_code": "471117733",
            "country_code": "US",
            "telephone_number": "812-777-5759",
            "fax_number": "812-725-7865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEIST",
        "first_name": "SHANNON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-21",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "33007313A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008294A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "WALLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Lee, PA
• Steven Lee
• Amy Leezer, APRN
• Leslie Walton Leffler, APRN
• Macauley Legg
• Stacey Lengacher, LMT
• Kristy Ann Lenwell, D.C.
• Kaila Marie Lepora, OD
• Julie Lerch
• Leslie Strouse, M.D., PSC

• Clinical Social Worker in New Albany, IN
• Providers in New Albany, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.