MS. SHELLY HANSEN – Counselor, NPI 1164078762

MS. SHELLY HANSEN is a healthcare provider. based in Rock island, Illinois. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 149.025995 (IL). The NPI Number for MS. SHELLY HANSEN is 1164078762

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
MS. SHELLY HANSEN
NPI
1164078762
Phone
(309) 779-2031
Address
2701 17TH ST
Enumeration Date
11 August 2019
Last Update Date
29 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5634450557
Graduation Year
2021 (5 years ago)
PAC ID
9830634062
Group Practice PAC ID
5698841294
Professional Enrollment ID
I20240712000432
Address ID
IA528042148DA1414XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:6State licenses:2Digital endpointsOther names

3,510 CLINICAL SOCIAL WORKER in IL

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Provider Addresses for MS. SHELLY HANSEN

  • UnityPoint Health - Trinity, 2701, 17th Street, Rock Island, Rock Island County, Illinois, 61201, United States

    ROCK ISLAND, IL 612015351

    Phone: (309) 779-2031

    Type: Mailing

  • 1414 W LOMBARD ST

    DAVENPORT, IA 528042148

    Phone: (563) 326-6431

    Type: Mailing

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: 2024-07-12

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
I20240712000432IClinical Social WorkerIATBD

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 61201)

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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: 5698841294View full group profile
NameSpecialtyState
Clinical PsychologistIA
-IA
Clinical Social WorkerIA
-IA

Reviews

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Frequently asked questions

What is MS. SHELLY HANSEN's NPI number?
MS. SHELLY HANSEN's NPI is 1164078762 — the number used across U.S. healthcare to identify this provider.
Is MS. SHELLY HANSEN still an active registrant?
MS. SHELLY HANSEN carries an active NPI according to the public dataset.
How would a patient describe MS. SHELLY HANSEN's focus?
For MS. SHELLY HANSEN, the primary taxonomy reads as Counselor. Clinical services aligned with this taxonomy classification.
Is MS. SHELLY HANSEN associated with Rock Island?
Public fields place MS. SHELLY HANSEN around Rock Island, Illinois. Always confirm the exact site before visiting.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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