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SHANDRA THEA ROTENBERRY LICSW
NPI 1053884528
Social Worker - Clinical in Liberty Lake, WA

Active since January 08, 2019PECOS EnrolledAccepts Medicare Assignment
23505 E APPLEWAY AVE STE 200-540, LIBERTY LAKE, WA 99019(253) 465-2236 Get Directions Write a Review

NPPES record last updated: May 3, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 3, 2026, Mar 26, 2025, Jan 8, 2019 (3 updates tracked since 2019).

About Shandra Thea Rotenberry Licsw NPPES

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

SHANDRA THEA ROTENBERRY LICSW (NPI 1053884528) is an individual clinical provider in Liberty Lake, Washington, licensed in Washington (LW60854195) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1053884528
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSHANDRA THEA ROTENBERRYCredential: LICSW
Location Address23505 E APPLEWAY AVE STE 200-540Liberty Lake, WA 99019-6065
Mailing Address1484 Marion County 4003Yellville, AR 72687-9343 · (714) 356-8077
Phone(253) 465-2236
Sole ProprietorYes
Medical School CMSOtherGraduated 2013
Enumeration DateJanuary 8, 2019
Last NPPES UpdateMay 3, 20263 updates tracked since enumeration
NPPES CertifiedMay 3, 2026
✔ NPI 1053884528 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in WA · LW60854195
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.
23505 E APPLEWAY AVE STE 200-540, Liberty Lake, WA 99019
Open in Google Maps ↗

Secondary Practice Locations 3

Location 11030 N Center PkwyKennewick, WA 99336-7160 · Phone (253) 465-2236
Location 21106 Clayton Ln Ste 501WAustin, TX 78723-1085 · Phone (253) 465-2236
Location 33537 N Steele Blvd Ste 110Fayetteville, AR 72703-5631 · Phone (253) 465-2236

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, BridgeSpan Health Company, Cigna Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shandra Thea Rotenberry Licsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6901339449
PECOS Enrollment IDI20241023000999
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 Shandra Rotenberry reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mindful Therapy Group PC
244 mi
Clinical
6505 216TH ST SW STE 100
Mountlake Terrace, WA 98043
  • Reassigned Medicare billing, Washington enrollment
  • 777 clinicians in this Medicare group
NPI 1316238678 (425) 640-7009

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 99019 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

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

THERAPY CORNER & CONSULTING, PROFESSIONAL CORPORATION
Social Worker (Clinical)
23505 E APPLEWAY AVE STE 200-540
LIBERTY LAKE, WA 99019
Spokane County (714) 356-8077

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 Shandra Rotenberry's NPI number?

The NPI number for Shandra Rotenberry is 1053884528. It was assigned to this individual provider in the NPPES registry on January 8, 2019.

Where is Shandra Rotenberry located?

Shandra Rotenberry practices at 23505 E Appleway Ave Ste 200-540, Liberty Lake, WA 99019. The listed phone number is (253) 465-2236.

What is Shandra Rotenberry's specialty?

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

Is Shandra Rotenberry enrolled in Medicare?

Yes. Shandra Rotenberry is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Shandra Rotenberry's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shandra Rotenberry reassigns Medicare benefits to Mindful Therapy Group PC (Mountlake Terrace, 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 Shandra Rotenberry's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shandra Rotenberry accept?

Health plans from Blue Cross and Blue Shield of Texas, BridgeSpan Health Company, Cigna Healthcare and Regence BlueCross BlueShield of Oregon list Shandra Rotenberry 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 Shandra Rotenberry was last updated on May 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.