SHAWN S. GRAVELLE (LPCC) – Professional Counselor, NPI 1295855963

SHAWN S. GRAVELLE (LPCC) is a healthcare provider. based in Chubbuck, Idaho. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPCC. They hold a License No. LPC3523 (ID). The NPI Number for SHAWN S. GRAVELLE (LPCC) is 1295855963

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
SHAWN S. GRAVELLE (LPCC)
NPI
1295855963
Phone
(208) 380-0545
Address
771 PINEWOOD ST
Enumeration Date
29 March 2007
Last Update Date
22 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9523951441
Graduation Year
2004 (22 years ago)
PAC ID
4284081126
Group Practice PAC ID
6406752492
Professional Enrollment ID
I20231114001822
Address ID
MN553181009CH1107XBLVD301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience76
Completeness75
Years active:19State licenses:2Digital endpointsOther names

436 MENTAL HEALTH COUNSELOR in ID

Provider Addresses for SHAWN S. GRAVELLE (LPCC)

  • 771 PINEWOOD ST

    CHUBBUCK, ID 832022651

    Phone: (208) 380-0545

    Type: Mailing

  • 210 E CENTER ST

    SUITE B

    POCATELLO, ID 832016326

    Phone: (208) 234-2600

    Type: Location

  • 1900 SILVER LAKE RD NW STE 110

    NEW BRIGHTON, MN 551121789

    Phone: (651) 628-9566

    Fax: (651) 628-0411

    Type: Mailing

  • 1107 HAZELTINE BLVD STE 370

    CHASKA, MN 553181009

    Phone: (952) 395-1441

    Fax: (651) 395-1442

    Type: Location

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.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-11-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231114001822IMental Health CounselorMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 83202)

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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: 6406752492View full group profile
NameSpecialtyState
-GA
Mental Health CounselorMN
Marriage And Family TherapistMN
Clinical PsychologistMN
Mental Health CounselorMN
Clinical PsychologistMN
Mental Health CounselorMN
Mental Health CounselorMN
Mental Health CounselorMN
-MN

Reviews

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Frequently asked questions

Does SHAWN S. GRAVELLE (LPCC) have a public NPI I can cite?
Public records show SHAWN S. GRAVELLE (LPCC) under NPI 1295855963.
Is SHAWN S. GRAVELLE (LPCC) currently accepting referrals based on NPI status?
Registry metadata lists SHAWN S. GRAVELLE (LPCC) as active.
What services align with SHAWN S. GRAVELLE (LPCC)'s listing?
SHAWN S. GRAVELLE (LPCC)'s public classification highlights Professional Counselor. Clinical services aligned with this taxonomy classification.
What geographic area is tied to SHAWN S. GRAVELLE (LPCC)?
SHAWN S. GRAVELLE (LPCC) is associated with Chubbuck, Idaho in the same public data insurers reference.
Can I export SHAWN S. GRAVELLE (LPCC)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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