KATHLEEN MARIE SHANNON (LISW) – Social Worker, NPI 1225137219

KATHLEEN MARIE SHANNON (LISW) is a healthcare provider. based in Warren, Ohio. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LISW. They hold a License No. I.0003968-SUPV (OH). The NPI Number for KATHLEEN MARIE SHANNON (LISW) is 1225137219

Main info

Female
Sole Proprietor
43 Years Of Experience
Accepts Medicare Assignment
Name
KATHLEEN MARIE SHANNON (LISW)
NPI
1225137219
Phone
(330) 787-0955
Address
4930 Enterprise Dr NW
Enumeration Date
22 September 2006
Last Update Date
3 September 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1983 (43 years ago)
PAC ID
9234278375
Group Practice PAC ID
8820334931
Professional Enrollment ID
I20091202000260
Address ID
OH445124370YO725XXRDXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience66
Completeness75
Years active:19State licenses:2Digital endpointsOther names

2,650 CLINICAL SOCIAL WORKER in OH

Provider Addresses for KATHLEEN MARIE SHANNON (LISW)

  • 4930 Enterprise Dr NW

    Warren, OH 444818706

    Phone: (330) 787-0955

    Type: Location

  • Elsinore Place, Walnut Hills, Cincinnati, Hamilton County, Ohio, 45202, United States

    CINCINNATI, OH 452021459

    Phone: (513) 834-7063

    Fax: (513) 873-1567

    Type: Mailing

  • 930, Trailwood Drive, Copley Professional Center, Boardman, Boardman Township, Mahoning County, Ohio, 44512, United States

    BOARDMAN, OH 445125007

    Phone: (513) 834-7063

    Fax: (513) 873-1567

    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: 2009-12-02

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
I20091202000260IClinical Social WorkerOHTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour7921$0
90832Psychotherapy, 30 minutes4512$0
View full utilization report →

Insurance plans in this area (ZIP 44481)

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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: 8820334931View full group profile
NameSpecialtyState
Clinical Social WorkerOH
Clinical Social WorkerPA
Mental Health CounselorOH
Mental Health CounselorOH
Marriage And Family TherapistOH
Clinical Social WorkerOH
Clinical Social WorkerOH
Mental Health CounselorOH
Clinical Social WorkerOH
Mental Health CounselorOH

Reviews

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Frequently asked questions

Is KATHLEEN MARIE SHANNON (LISW) listed with a National Provider Identifier?
Yes — KATHLEEN MARIE SHANNON (LISW) has NPI 1225137219 on file in the registry.
Is KATHLEEN MARIE SHANNON (LISW) shown as active in public data?
Registry records indicate KATHLEEN MARIE SHANNON (LISW) maintains an active NPI.
How would a patient describe KATHLEEN MARIE SHANNON (LISW)'s focus?
For KATHLEEN MARIE SHANNON (LISW), the primary taxonomy reads as Social Worker. Clinical services aligned with this taxonomy classification.
What locale is associated with KATHLEEN MARIE SHANNON (LISW)?
Directory geography for KATHLEEN MARIE SHANNON (LISW) centers on Warren, Ohio.
When was this NPI issued?
Enumeration for KATHLEEN MARIE SHANNON (LISW) is noted as September 22, 2006 where the registry provides it.