SHANNON L WILSON (LCSW) – Clinical Social Worker, NPI 1013396175

Clinical Social Worker

SHANNON L WILSON (LCSW) is a healthcare provider. based in Mountain home afb, Idaho. specializing in Clinical Social Worker. They hold the professional credentials LCSW. They hold a License No. LCSW-36402 (ID). The NPI Number for SHANNON L WILSON (LCSW) is 1013396175

Main info

Female

Sole Proprietor

13 Years Of Experience

Accepts Medicare Assignment

Name

SHANNON L WILSON (LCSW)

NPI

1013396175

Phone

(208) 828-7500

Address

90 HOPE DR BLDG 6000

Enumeration Date

22 May 2015

Last Update Date

1 December 2025

Doctor Profile

Medical School Name

OTHER

Secondary Phone

2087367090

Graduation Year

2013 (13 years ago)

PAC ID

3779835160

Group Practice PAC ID

8921257130

Professional Enrollment ID

I20181012001484

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience55

Completeness85

Years active:11State licenses:2Digital endpointsOther names

Provider Addresses for SHANNON L WILSON (LCSW)

90 HOPE DR BLDG 6000
MOUNTAIN HOME AFB, ID 836481062
Phone: (208) 828-7500
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83648)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 8921257130View full group profile

Name	Specialty	State
KRISTAN NICHOLE FRENCH (LCSW)	Clinical Social Worker	ID
MRS. AMADEA DE GROOT (LPC)	Mental Health Counselor	ID
MR. STEVEN VAN PARKER (LPC, HI, DS)	Mental Health Counselor	ID
MR. MICHAEL ROBERT GRITTON (LPC)	Mental Health Counselor	ID
MARK CHAPPEL (LPC)	Mental Health Counselor	ID
JENNIE REBECCA FULLMER (LPC)	Mental Health Counselor	ID
ALLISON WELCH (LPC)	Mental Health Counselor	ID
PATRICIA HUTCHINSON (LCSW)	-	ID