KATIE JO SHADRICK (MA, LPCC) – Mental Health Counselor, NPI 1275015786

KATIE JO SHADRICK (MA, LPCC) is a healthcare provider. based in Eden prairie, Minnesota. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA, LPCC. They hold a License No. CC01886 (MN). The NPI Number for KATIE JO SHADRICK (MA, LPCC) is 1275015786

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
KATIE JO SHADRICK (MA, LPCC)
NPI
1275015786
Phone
(952) 746-2522
Address
11010 Prairie Lakes Dr Ste 350
Enumeration Date
30 August 2018
Last Update Date
30 March 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5073013412
Graduation Year
2012 (14 years ago)
PAC ID
2860931037
Group Practice PAC ID
8628409299
Professional Enrollment ID
I20240902000010
Address ID
MN550572756NO570XXDRXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:7State licenses:1Digital endpointsOther names

1,813 MENTAL HEALTH COUNSELOR in MN

Provider Addresses for KATIE JO SHADRICK (MA, LPCC)

  • 11010 Prairie Lakes Dr Ste 350

    Eden Prairie, MN 553443801

    Phone: (952) 746-2522

    Type: Location

  • 1310, South German Street, New Ulm, Brown County, Minnesota, 56073, United States

    NEW ULM, MN 560733478

    Phone:

    Type: Mailing

  • 113 E Hickory St

    Mankato, MN 560013630

    Phone: (507) 388-8114

    Fax: (507) 388-8068

    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: 2024-09-02

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
I20240902000010IMental 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 55344)

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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: 8628409299View full group profile
NameSpecialtyState
Mental Health CounselorOR
Marriage And Family TherapistMN
Clinical Social WorkerMN
Clinical Social WorkerMN
Mental Health CounselorFL
Mental Health CounselorMN
Mental Health CounselorMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Mental Health CounselorMN

Reviews

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Frequently asked questions

Does KATIE JO SHADRICK (MA, LPCC) have a public NPI I can cite?
Public records show KATIE JO SHADRICK (MA, LPCC) under NPI 1275015786.
Quick check: is KATIE JO SHADRICK (MA, LPCC) active?
Public NPPES data shows KATIE JO SHADRICK (MA, LPCC) with an active NPI status right now.
How should patients interpret KATIE JO SHADRICK (MA, LPCC)'s specialty?
The extract shows Mental Health Counselor for KATIE JO SHADRICK (MA, LPCC). Clinical services aligned with this taxonomy classification.
Is KATIE JO SHADRICK (MA, LPCC) tied to Eden Prairie, Minnesota?
If you are local to Eden Prairie, Minnesota, KATIE JO SHADRICK (MA, LPCC) may be relevant to your search.
Can I export KATIE JO SHADRICK (MA, LPCC)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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