SHANNON RENE VEGA (LICSW) – Counselor, NPI 1952672792

SHANNON RENE VEGA (LICSW) is a healthcare provider. based in Olympia, Washington. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. The NPI Number for SHANNON RENE VEGA (LICSW) is 1952672792

Main info

Female
10 Years Of Experience
Name
SHANNON RENE VEGA (LICSW)
NPI
1952672792
Phone
(360) 878-8248
Address
1011 10TH AVE SE
Enumeration Date
25 January 2012
Last Update Date
28 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2535335768
Graduation Year
2016 (10 years ago)
PAC ID
8426402306
Group Practice PAC ID
1557752110
Professional Enrollment ID
I20230926003012
Address ID
WA984242315FI3203XEXXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:14State licenses:0Digital endpointsOther names

548 CLINICAL SOCIAL WORKER in NV

Provider Addresses for SHANNON RENE VEGA (LICSW)

  • 1011 10TH AVE SE

    OLYMPIA, WA 985011566

    Phone: (360) 878-8248

    Type: Mailing

  • 4606 N Cactus Hills Ct

    Sparks, NV 894362632

    Phone: (866) 622-4837

    Fax: (775) 622-4837

    Type: Location

  • 2209 COOKS HILL RD

    CENTRALIA, WA 985319076

    Phone: (775) 685-9913

    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: 2023-09-26

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
I20230926003012IClinical Social WorkerWATBD

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 98501)

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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: 1557752110View full group profile
NameSpecialtyState
Nurse PractitionerWA
Nurse PractitionerFL
Nurse PractitionerWA

Reviews

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Frequently asked questions

What is the registry number for SHANNON RENE VEGA (LICSW)?
The registry entry for SHANNON RENE VEGA (LICSW) shows NPI 1952672792.
Should I treat SHANNON RENE VEGA (LICSW) as an active provider?
Patients and plans typically see SHANNON RENE VEGA (LICSW) as active in the national extract.
Which specialty label fits SHANNON RENE VEGA (LICSW)?
NPPES ties SHANNON RENE VEGA (LICSW) to Counselor in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to SHANNON RENE VEGA (LICSW)?
SHANNON RENE VEGA (LICSW) shows a connection to Olympia, Washington in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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