MRS. SHANNON BOLTER LADC, IADC, PCDGC
NPI 1376177071
Counselor - Addiction (Substance Use Disorder) in Omaha, NE

Q: What is Shannon Bolter's NPI number?

The NPI number for Shannon Bolter is 1376177071. It was assigned to this individual provider in the NPPES registry on March 3, 2020.

Q: What is Shannon Bolter's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Shannon Bolter was last updated on November 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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 March 03, 2020PECOS Enrolled

108 N 49TH ST STE B103, OMAHA, NE 68132(402) 200-3808 Get Directions Write a Review

NPPES record last updated: November 14, 2024. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Nov 14, 2024, Aug 1, 2022, Mar 3, 2020 (3 updates tracked since 2020).

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About Mrs. Shannon Bolter Ladc, Iadc, Pcdgc NPPES

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

MRS. SHANNON BOLTER LADC, IADC, PCDGC (NPI 1376177071) is an individual addiction (substance use disorder) provider in Omaha, Nebraska, licensed in Nebraska (1439) and active in the NPI registry since March 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1376177071

Entity TypeIndividualFemale

Primary Taxonomy101YA0400X

Provider Legal NameMRS. SHANNON BOLTERCredential: LADC, IADC, PCDGC

Location Address108 N 49TH ST STE B103Omaha, NE 68132-3172

Mailing Address108 N 49th St Ste B103Omaha, NE 68132-3172 · (402) 200-3808

Phone(402) 200-3808

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateMarch 3, 2020

Last NPPES UpdateNovember 14, 20243 updates tracked since enumeration

NPPES CertifiedNovember 14, 2024

✔ NPI 1376177071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

Licenses✔ Licensed in NE · 1439✔ Licensed in IA · 22R101✔ Licensed in NE · 51

108 N 49TH ST STE B103, Omaha, NE 68132

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Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Shannon Bolter Ladc, Iadc, Pcdgc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3072090471

PECOS Enrollment IDI20260115003458

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.

Other Providers at the Same Location NPPES

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

RESILIENCY AND RECOVERY

Counselor (Addiction (Substance Use Disorder))

108 N 49TH ST STE B103
OMAHA, NE 68132

Douglas County (402) 200-3808

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 Shannon Bolter's NPI number?

The NPI number for Shannon Bolter is 1376177071. It was assigned to this individual provider in the NPPES registry on March 3, 2020.

Where is Shannon Bolter located?

Shannon Bolter practices at 108 N 49th St Ste B103, Omaha, NE 68132. The listed phone number is (402) 200-3808.

What is Shannon Bolter's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Shannon Bolter enrolled in Medicare?

Yes. Shannon Bolter is registered in the Medicare PECOS enrollment system.

What insurance does Shannon Bolter accept?

Health plans from Blue Cross and Blue Shield of Nebraska list Shannon Bolter 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 Shannon Bolter was last updated on November 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.