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JEFF WILLIAM SHIVELY LICSW
NPI 1376782961
Social Worker - Clinical in Plymouth, MN

Active since February 05, 2009PECOS Enrolled
12805 HIGHWAY 55, SUITE 200, PLYMOUTH, MN 55441(612) 723-0408(763) 210-5379 Get Directions Write a Review

NPPES record last updated: March 5, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jeff William Shively Licsw NPPES

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

JEFF WILLIAM SHIVELY LICSW (NPI 1376782961) is an individual clinical provider in Plymouth, Minnesota, licensed in Minnesota (18053) and active in the NPI registry since February 2009. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1376782961
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameJEFF WILLIAM SHIVELYCredential: LICSW
Location Address12805 HIGHWAY 55, SUITE 200Plymouth, MN 55441-3859
Mailing Address12805 Highway 55, Suite 200Plymouth, MN 55441-3859 · (612) 723-0408 · Fax (763) 210-5379
Phone(612) 723-0408
Fax(763) 210-5379
Sole ProprietorNo
Enumeration DateFebruary 5, 2009
Last NPPES UpdateMarch 5, 2013
✔ NPI 1376782961 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 MN · 18053
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.
12805 HIGHWAY 55, Plymouth, MN 55441
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Providence Health Plan.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)

Jeff William Shively 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55441 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 $56.00 – $168.28
Typical copayment $0.00 (range $14.00 – $42.07)
Most-billed visit code NA
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
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 19

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

LAURIS J PRINSEN L.A.D.C.
Counselor (Mental Health)
12805 HIGHWAY 55, SUITE 211
PLYMOUTH, MN 55441
Hennepin County (763) 550-9005
NAVIGATING CHANGES LLC
Marriage & Family Therapist
12805 HIGHWAY 55, SUITE 402
PLYMOUTH, MN 55441
Hennepin County (612) 643-0046
CHRISTINE S CHANG MD
Family Medicine
12805 HIGHWAY 55, SUITE 111
PLYMOUTH, MN 55441
Hennepin County (763) 577-2060
AUTISM FAMILY THERAPY INC
Marriage & Family Therapist
12805 HIGHWAY 55, SUITE 402
PLYMOUTH, MN 55441
Hennepin County (612) 597-0459
PAMELA RAE GALBRAITH M.S., L.P.C.
Counselor (Professional)
12805 HIGHWAY 55, SUITE 211
PLYMOUTH, MN 55441
Hennepin County (763) 550-9005
KRISTIN CARPENTER LMT
Massage Therapist
12805 HIGHWAY 55, SUITE 210
PLYMOUTH, MN 55441
Hennepin County (763) 550-0892
ROGER LEE REDDAN M.A., L.P.
Psychologist (Counseling)
12805 HIGHWAY 55, SUITE 211
PLYMOUTH, MN 55441
Hennepin County (763) 550-9005
JEFF SHIVELY, MSW, LICSW
Social Worker (Clinical)
12805 HIGHWAY 55, SUITE 200
PLYMOUTH, MN 55441
Hennepin County (612) 723-0408

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 Jeff Shively's NPI number?

The NPI number for Jeff Shively is 1376782961. It was assigned to this individual provider in the NPPES registry on February 5, 2009.

Where is Jeff Shively located?

Jeff Shively practices at 12805 Highway 55 Suite 200, Plymouth, MN 55441. The listed phone number is (612) 723-0408.

What is Jeff Shively's specialty?

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

Is Jeff Shively enrolled in Medicare?

Yes. Jeff Shively is registered in the Medicare PECOS enrollment system.

What insurance does Jeff Shively accept?

Health plans from HealthPartners and Providence Health Plan list Jeff Shively 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 Jeff Shively was last updated on March 5, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.