Shannon L Radlo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

009782 Issued in CT

Practice address

44 Sherman St
Springfield, MA 01109-3517

Phone

(413) 739-5626

NPI assigned

Sep 14, 2012

Last updated

Oct 5, 2020By 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 2

Addresses

Other names 1

• Shannon McNamara Former name

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Mindful Matters Counseling, LLC

  dba Mindful Matters Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stafford Springs, CT
  • NPI 1972079796
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1881944015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 252",
            "city": "COVENTRY",
            "state": "CT",
            "postal_code": "062380252",
            "telephone_number": "860-712-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 SHERMAN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011093517",
            "telephone_number": "413-739-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADLO",
        "first_name": "SHANNON",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "MCNAMARA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tyler A Racine, LPN
• Nicholas Radigan, MD
• Radiology & Imaging Inc
• Radiology & Imaging, Inc.
• Radiology and Imaging, Inc.
• Mark Alan Radzicki, MD
• Kailey Radziszewski
• Sandra J Rae, RNC,WHNP
• Rafa Transportation
• Aneta B Rafalowski, M.D.

• Clinical Social Worker in Springfield, MA
• Providers in Springfield, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.