Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shandra Thea Rotenberry, LICSW

Individual provider Clinical Social Worker · NPI 1053884528

Shandra Thea Rotenberry, LICSW is a Clinical Social Worker in Liberty Lake, Washington. Qualified in 2013, 13 years ago. Practices with Mindful Therapy Group PC, a 646-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
13
Licensed in
WA
In the registry since
2019
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

23505 E Appleway Ave Ste 200-540
Liberty Lake, WA 99019-6065
Phone: (253) 465-2236
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 3537 N Steele Blvd Ste 110, Fayetteville, AR 72703-5631 — (253) 465-2236
  • 1106 Clayton Ln Ste 501w, Austin, TX 78723-1085 — (253) 465-2236
  • 1030 N Center Pkwy, Kennewick, WA 99336-7160 — (253) 465-2236

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LW60854195 (WA)

Record details

NPI number1053884528
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedJanuary 8, 2019
Last updated in NPPESMay 3, 2026
Certification dateMay 3, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Mindful Therapy Group Pc — 646 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Liberty Lake