EMMA FAYE SHANNON (MSW, LICSW) – Clinical Social Worker, NPI 1013404839
Clinical Social Worker
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for EMMA FAYE SHANNON (MSW, LICSW)
51, Glastonbury Circuit, Newminster, Point Cook, Melbourne, City of Wyndham, Victoria, 3030, Australia
VICTORIA, MN 553860051
Phone: (952) 443-4600
Fax: (952) 443-4604
Type: Mailing
Hastings Avenue Southeast, Prior Lake, Scott County, Minnesota, 55372, United States
PRIOR LAKE, MN 553729227
Phone: (952) 443-4600
Fax: (952) 443-4604
Type: Location
16180 Hastings Ave SE
Prior Lake, MN 553729227
Phone: (952) 443-4600
Fax: (952) 443-4604
Type: Location
1502 LONDON RD STE 205
DULUTH, MN 558121788
Phone: (612) 234-4689
Fax: (612) 234-4689
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: 2018-06-18
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180618000859 | I | Clinical Social Worker | MN | TBD |
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.
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 55386)
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