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

Shannon M Anderson

Individual provider Clinical Social Worker · NPI 1053043398

Shannon M Anderson is a Clinical Social Worker in Green Bay, Wisconsin. Qualified in 2022, 4 years ago. Practices with Innovative Counseling Inc, a 15-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
4
Licensed in
WI
In the registry since
2022

Practice location Address checks out

1499 6th St
Green Bay, WI 54304-2252
Phone: (920) 497-6161
Fax: (888) 974-5769
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X (WI)

Record details

NPI number1053043398
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 27, 2022
Last updated in NPPESJune 27, 2022
Certification dateJune 27, 2022

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Innovative Counseling Inc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Green Bay