Shannon Mary McGinnis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10664 Issued in CT

Practice address

370 Boston Post Rd
Orange, CT 06477-3534

Phone

(203) 553-9949

NPI assigned

Jul 8, 2019

Last updated

Mar 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Achieve Wellness, LLCGroup PAC ID 6709293749, 2 clinicians

Practice addresses (Care Compare)

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.

• Achieve Wellness, LLC

  • Clinical Social Worker
  • Orange, CT
  • NPI 1194271999
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1952963233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 OLD TAVERN RD",
            "address_2": "UNIT 120",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773450",
            "telephone_number": "203-808-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 BOSTON POST RD",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064773534",
            "telephone_number": "203-553-9949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Old Tavern Rd Unit 120",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CT",
            "postal_code": "064773450",
            "country_code": "US",
            "telephone_number": "203-553-9949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGINNIS",
        "first_name": "SHANNON",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "10664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Mattiaccio, PMHNP-BC
• Gladys Mayes, LCSW
• Sharon M McCreven, RDH
• Marcus McFerren, MD, PHD
• Liam McGinley, DPT
• Heather Anne McVey, OTR/L
• Med-Aid LLC
• Medical Oncology & Hematology PC (Diagnostic Hematology Lab)
• Medtech
• Rebecca Mennillo, APRN

• Clinical Social Worker in Orange, CT
• Providers in Orange, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.