Individual provider Active NPI

Shannon Wilhelm, LCSW

  • Clinical Social Worker
  • Salem, OR
National Provider Identifier
1952879124
Registry record updated Nov 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2421 Lancaster Dr NE
Salem, OR 97305-1220
Phone
(503) 576-4673
NPI assigned
Nov 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

2421 Lancaster Dr NE
Salem, OR 97305-1220

Mailing address

2421 Lancaster Dr NE
Salem, OR 97305-1220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20200622002899 OR Practitioner - Clinical Social Worker 7113349069 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Marion County CurrentSince Mar 1, 2020 Accepting new patients
Marion County CurrentSince Mar 1, 2020 Accepting new patients

Locations

2045 Silverton Rd NE
Salem, OR 97301
Phone (503) 576-4589

2421 Lancaster Dr NE
Salem, OR 97305
Phone (503) 585-4977

3180 Center St NE
Ste 2200
Salem, OR 97301

Organizations & group practices 2

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": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1952879124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 LANCASTER DR NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051220",
            "telephone_number": "503-576-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHELM",
        "first_name": "SHANNON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.