Active NPI
Shannon D. Lyon, LCSW
- Social Worker
- Tooele, UT
National Provider Identifier
1902130123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 7047395-3502
- Practice address
- 66 W Vine St Ste B
Tooele, UT 84074-2185 - Phone
- (435) 241-4920
- NPI assigned
- Sep 21, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 7047395-3502 | UT | Primary |
Addresses
Primary practice location
66 W Vine St Ste B
Tooele, UT 84074-2185
Mailing address
PO Box 435
Tooele, UT 84074-0435
Phone (435) 224-3213
Other names 1
- Mrs. Shannon D. Sagers
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2017 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7047395-3502 | UT | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638144000000",
"number": "1902130123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 435",
"city": "TOOELE",
"state": "UT",
"postal_code": "840740435",
"telephone_number": "435-224-3213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 W VINE ST STE B",
"city": "TOOELE",
"state": "UT",
"postal_code": "840742185",
"telephone_number": "435-241-4920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYON",
"first_name": "SHANNON",
"middle_name": "D.",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-21",
"last_updated": "2021-11-29",
"certification_date": "2021-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "UT",
"license": "7047395-3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHANNON",
"last_name": "SAGERS",
"middle_name": "D.",
"prefix": "MRS.",
"credential": "MSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Tooele, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.