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MR. SHAD BURNETT ST PAUL MSW, SUDP, LICSW
NPI 1033503107
Social Worker - Clinical in Inchelium, WA

Active since March 26, 2015PECOS Enrolled
39 SHORT CUT ROAD, INCHELIUM, WA 99138(509) 722-7640 Get Directions Write a Review

NPPES record last updated: November 18, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 18, 2024, Nov 14, 2024, Apr 6, 2023 and 2 more (5 updates tracked since 2018).

About Mr. Shad Burnett St Paul Msw, Sudp, Licsw NPPES

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

MR. SHAD BURNETT ST PAUL MSW, SUDP, LICSW (NPI 1033503107) is an individual clinical provider in Inchelium, Washington, licensed in Washington (LW61381427) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033503107
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. SHAD BURNETT ST PAULCredential: MSW, SUDP, LICSW
Location Address39 SHORT CUT ROADInchelium, WA 99138-0039
Mailing AddressPo Box 290Inchelium, WA 99138-0290 · (509) 722-7640
Phone(509) 722-7640
Sole ProprietorNo
Enumeration DateMarch 26, 2015
Last NPPES UpdateNovember 18, 20245 updates tracked since enumeration
NPPES CertifiedNovember 14, 2024
✔ NPI 1033503107 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 WA · LW61381427
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 ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License CP60472921 (WA)
39 SHORT CUT ROAD, Inchelium, WA 99138
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Shad Burnett St Paul Msw, Sudp, Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Shad St Paul reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Colville Nation Community Health Centers
Same address
Federally Qualified Health Center (FQHC)
39 SHORTCUT ROAD
Inchelium, WA 99138
  • Reassigned Medicare billing, Texas enrollment
  • 20 clinicians in this Medicare group
NPI 1043335961 (509) 722-7006

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99138 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $57.27 – $172.80
Typical copayment $0.00 (range $14.31 – $43.20)
Most-billed visit code NA
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

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

LAKE ROOSEVELT COMMUNITY HEALTH CENTERS
Family Medicine
39 SHORT CUT ROAD
INCHELIUM, WA 99138
Ferry County (509) 722-7610
BESSIE JEAN NUGENT D.A.
Dental Assistant
39 SHORT CUT ROAD
INCHELIUM, WA 99138
Ferry County (509) 722-7013
LESLIE ANN LAHR M.A
Technician, Other
39 SHORT CUT ROAD
INCHELIUM,, WA 99138
Ferry County (509) 722-7006

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shad St Paul's NPI number?

The NPI number for Shad St Paul is 1033503107. It was assigned to this individual provider in the NPPES registry on March 26, 2015.

Where is Shad St Paul located?

Shad St Paul practices at 39 Short Cut Road, Inchelium, WA 99138. The listed phone number is (509) 722-7640.

What is Shad St Paul's specialty?

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

Is Shad St Paul enrolled in Medicare?

Yes. Shad St Paul is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shad St Paul's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shad St Paul reassigns Medicare benefits to Colville Nation Community Health Centers (Inchelium, WA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shad St Paul's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shad St Paul accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Shad St Paul as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shad St Paul was last updated on November 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.