Mrs Shannon A Perez, MSW, LCSW, LCAS-A is a medicare enrolled "Social Worker - Clinical" provider in Southport, North Carolina. She graduated from healthcare school in 2019 and has 5 years of diverse experience with area of expertise as Clinical Social Worker. Her current practice location is
8128 River Rd Se, Southport, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(910) 367-5036.
Mrs Shannon A Perez is licensed to practice in North Carolina (license number C014152) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1083232631.
Healthcare Provider's Profile
| Full Name | Mrs Shannon A Perez |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 5 Years |
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| Location | 8128 River Rd Se, Southport, North Carolina |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mrs Shannon A Perez graduated from medical school in 2019
NPI Data:
- NPI Number: 1083232631
- Provider Enumeration Date: 07/09/2020
- Last Update Date: 08/17/2023
Medicare PECOS Information:
- PECOS PAC ID: 6507254018
- Enrollment ID: I20211102000812
Medical Identifiers
Medical identifiers for Mrs Shannon A Perez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1083232631 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 25841 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | P013774 (North Carolina) | Secondary |
| 1041C0700X | Social Worker - Clinical | C014152 (North Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Shannon A Perez allows following entities to bill medicare on her behalf.
| Entity Name | Mindful Expressions Counseling Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134894850
PECOS PAC ID: 5698163103
Enrollment ID: O20211102000726 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Shannon A Perez is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mrs Shannon A Perez, MSW, LCSW, LCAS-A
70 High Point Rd,
Southport, NC 28461-9757
Ph: (910) 599-0993 | Mrs Shannon A Perez, MSW, LCSW, LCAS-A
8128 River Rd Se,
Southport, NC 28461-8972
Ph: (910) 367-5036 |
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