MRS. MARY SHANNON HAZEN (LCSW) – Mental Health Counselor, NPI 1043953797

MRS. MARY SHANNON HAZEN (LCSW) is a healthcare provider. based in Choctaw, Oklahoma. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 21587 (OK). The NPI Number for MRS. MARY SHANNON HAZEN (LCSW) is 1043953797

Main info

Female
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
MRS. MARY SHANNON HAZEN (LCSW)
NPI
1043953797
Phone
(405) 390-8131
Address
14625 NE 23rd St
Enumeration Date
19 April 2022
Last Update Date
19 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4052199283
Graduation Year
2015 (11 years ago)
PAC ID
7618481334
Professional Enrollment ID
I20250707001504
Address ID
OK748578834NE5021XRDXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Digital endpointsOther names

628 CLINICAL SOCIAL WORKER in OK

Provider Addresses for MRS. MARY SHANNON HAZEN (LCSW)

  • 14625 NE 23rd St

    Choctaw, OK 730208728

    Phone: (405) 390-8131

    Fax: (405) 835-2253

    Type: Location

  • PO BOX 695

    CHOCTAW, OK 730200695

    Phone: (405) 390-8131

    Fax: (405) 835-2253

    Type: Mailing

  • 14625 NE 23RD ST

    CHOCTAW, OK 730208728

    Phone: (405) 390-8131

    Fax: (405) 835-2253

    Type: Location

  • 5021 RED HILL RD

    NEWALLA, OK 748578834

    Phone: (405) 391-7777

    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: 2025-07-07

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
I20250707001504IClinical Social WorkerOKTBD

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 73020)

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Reviews

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Frequently asked questions

Is MRS. MARY SHANNON HAZEN (LCSW) listed with a National Provider Identifier?
Yes — MRS. MARY SHANNON HAZEN (LCSW) has NPI 1043953797 on file in the registry.
Is MRS. MARY SHANNON HAZEN (LCSW) shown as active in public data?
Registry records indicate MRS. MARY SHANNON HAZEN (LCSW) maintains an active NPI.
How would a patient describe MRS. MARY SHANNON HAZEN (LCSW)'s focus?
For MRS. MARY SHANNON HAZEN (LCSW), the primary taxonomy reads as Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MRS. MARY SHANNON HAZEN (LCSW)?
Travel planning: use Choctaw, Oklahoma as the reference point for MRS. MARY SHANNON HAZEN (LCSW), then confirm.
Does MRS. MARY SHANNON HAZEN (LCSW) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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