SHANNON L WILSON LCSW
NPI 1013396175
Social Worker - Clinical in Mountain Home Afb, ID

Q: What is Shannon Wilson's NPI number?

The NPI number for Shannon Wilson is 1013396175. It was assigned to this individual provider in the NPPES registry on May 22, 2015.

Q: What is Shannon Wilson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Wilson was last updated on December 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 22, 2015

90 HOPE DR BLDG 6000, MOUNTAIN HOME AFB, ID 83648(208) 288-7580 Get Directions Write a Review

NPPES record last updated: December 1, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 1, 2025, Aug 26, 2020 (2 updates tracked since 2020).

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About Shannon L Wilson Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON L WILSON LCSW (NPI 1013396175) is an individual clinical provider in Mountain Home Afb, Idaho, licensed in Idaho (LCSW-36402) and active in the NPI registry since May 2015.

NPPES Registry Identity

NPI1013396175

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameSHANNON L WILSONCredential: LCSW

Location Address90 HOPE DR BLDG 6000Mountain Home Afb, ID 83648-1062

Mailing Address90 Hope Dr Bldg 6000Mountain Home Afb, ID 83648-1062 · (208) 828-7500

Phone(208) 288-7580

Sole ProprietorYes

Enumeration DateMay 22, 2015

Last NPPES UpdateDecember 1, 20252 updates tracked since enumeration

NPPES CertifiedDecember 1, 2025

✔ NPI 1013396175 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in ID · LCSW-36402

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Also ListedSocial WorkerTaxonomy 104100000X · License LMSW-33063 (ID)

90 HOPE DR BLDG 6000, Mountain Home Afb, ID 83648

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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