Tacey A Shannon, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

076489-1 Issued in NY

Practice address

5 Pine St
Glens Falls, NY 12801-3502

Phone

(518) 745-0079

Fax

(518) 745-4291

NPI assigned

Nov 9, 2014

Last updated

Nov 9, 2014By 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 NY

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, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Adirondack Counseling LCSW PLLC

  • Clinical Social Worker
  • Glens Falls, NY
  • NPI 1255917043
  Medicare reassignment Authorized official
• New Hope Psychology and Nurse Practitioner-Psychiatry Services, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Glens Falls, NY
  • NPI 1710656350
  NPD (past)

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

{
    "created_epoch": "1415491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415491200000",
    "number": "1992101505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PINE ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013502",
            "telephone_number": "518-745-0079",
            "fax_number": "518-745-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PINE ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128013502",
            "telephone_number": "518-745-0079",
            "fax_number": "518-745-4291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "TACEY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-09",
        "last_updated": "2014-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "076489-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Servants of the Word (The Open Door)
• Jennifer L Sexton
• Annette M Seymour, MS CCC-SLP
• Shannon James Nurse Practitioner in Psychiatry P.C (The Eden Center for Integrative Care)
• Sharon H Shannon, NP
• Kenneth Lloyd Shapiro, MD
• Emily Elizabeth Sharpe
• Jeannelle M Shaver, RPA
• Linda Shearer, RD
• Kate Shelburne, D.O

• Social Worker in Glens Falls, NY
• Providers in Glens Falls, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2014; 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.