MRS. SHANNON KOSTUCK MSW, LCSW-A
NPI 1568892016
Social Worker - Clinical in Winston Salem, NC

NPI Status: Active since November 20, 2013

Contact Information

2101 PETERS CREEK PKWY
SUITE 20-22
WINSTON SALEM, NC
ZIP 27127
Phone: (336) 761-5300
Fax: (336) 761-5319

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  • Individual
  • Female
  • Social Worker
  • Clinical
  • Accepts Insurance
  • Opted-Out Medicare

About SHANNON KOSTUCK

This page provides the complete NPI Profile along with additional information for Shannon Kostuck, a provider established in Winston Salem, North Carolina with a medical specialization in Social Worker, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1568892016 assigned on November 2013. The practitioner's primary taxonomy code is 1041C0700X with license number P007907 (NC). The provider is registered as an individual and her NPI record was last updated 13 years ago.

NPI
1568892016
Provider Name
MRS. SHANNON KOSTUCK MSW, LCSW-A
Gender
Female
Entity Type
Individual
Location Address
2101 PETERS CREEK PKWY SUITE 20-22 WINSTON SALEM, NC 27127
Location Phone
(336) 761-5300
Location Fax
(336) 761-5319
Mailing Address
2101 PETERS CREEK PKWY SUITE 20-22 WINSTON SALEM, NC 27127
Mailing Phone
(336) 761-5300
Mailing Fax
(336) 761-5319
Is Sole Proprietor?
No
Enumeration Date
11-20-2013
Last Update Date
11-20-2013
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A clinical social worker like Shannon Kostuck is licensed to diagnose and treat mental, behavioral, and emotional disorders. A clinical social worker helps patients develop strategies to change behavior or cope with difficult situations and refer patients to other resources or services, such as support groups or other mental health professionals.

The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Shannon Kostuck opted out of Medicare effective on 10-01-2025 until 10-01-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Social Worker Clinical

Taxonomy Code
1041C0700X
Type
Behavioral Health & Social Service Providers
License No.
P007907
License State
NC
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Pathway/Lean HSA (+ Incentives) - HMO
  • Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
  • Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
  • Anthem Silver Pathway/Lean 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Pathway/Lean 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Better Together HMO Bronze 6500 Ded/8750 MOOP HSA - HMO
  • Better Together HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
  • Better Together HMO Bronze No Medical Ded/10600 MOOP HSA - HMO
  • Better Together HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
  • Better Together HMO Gold 2000 Ded/8200 MOOP - HMO
  • Better Together HMO Gold 4000 Ded/4000 MOOP HSA - HMO
  • Better Together HMO Platinum 750 Ded/2000 MOOP with Vision - HMO
  • Better Together HMO Platinum No Ded/3300 MOOP - HMO
  • Better Together HMO Platinum No Ded/5200 MOOP - HMO
  • Better Together HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
  • Better Together HMO Silver 5975 Ded/5975 MOOP HSA - HMO
  • Better Together HMO Silver 6000 Ded/8900 MOOP - HMO
  • Partners HMO Bronze 10600 Ded/10600 MOOP HSA - HMO
  • Partners HMO Bronze 6000 Ded/10600 MOOP HSA - HMO
  • Partners HMO Bronze 7500 Ded/10000 MOOP HSA - HMO
  • Partners HMO Gold 1500 Ded/8000 MOOP with Vision - HMO
  • Partners HMO Gold 2000 Ded/8200 MOOP - HMO
  • Partners HMO Gold 4000 Ded/4000 MOOP HSA - HMO
  • Partners HMO Silver 5500 Ded/8500 MOOP with Vision - HMO
  • Partners HMO Silver 5975 Ded/5975 MOOP HSA - HMO
  • Connect 1500 Gold - EPO
  • Connect 6000 Silver - EPO
  • Connect 9800 Bronze - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Providence Oregon Standard Silver Plan - Signature Network - EPO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE $10,150 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $0 MEDICAL DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) $10,150 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE BRONZE STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE CATASTROPHIC $10,600 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD $4,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) $4,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE $700 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD MAINTENANCE (DENTAL & VISION) $700 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE GOLD STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER $8,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER $9,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $8,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) $9,000 DED - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER (DENTAL & VISION) STANDARD EASY PRICING - HMO
  • QUARTZ GUNDERSEN PERFORMANCE SILVER STANDARD EASY PRICING - HMO
  • QUARTZ ONE ACHIEVE W/GUNDERSEN BRONZE $0 MEDICAL DED - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Opted-Out of Medicare? Yes

  • Opt-Out Effective Date: 10-01-2025

  • Opt-Out End Date: 10-01-2027

  • Eligible to Order and Refer? No

Reviews for MRS. SHANNON KOSTUCK MSW, LCSW-A

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1568892016, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
8
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
9
Unchanged
Pos 7
2
Doubled → 4
Pos 8
0
Unchanged
Pos 9
1
Doubled → 2
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 8 → 16 → 7 2 → 4 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 2 + 8 + 1 + 6 + 9 + 4 + 0 + 2 + 24 = 64

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1568892016.

Other Providers at the Same Location


The following 5 providers are registered at the same or a nearby location.

Physician Assistant (Medical)
2101 PETERS CREEK PKWY
WINSTON SALEM, NC 27127
Dentist (Dental Public Health)
2101 PETERS CREEK PKWY
WINSTON SALEM, NC 27127
Internal Medicine
2101 PETERS CREEK PKWY
WINSTON SALEM, NC 27127
Dentist
2101 PETERS CREEK PKWY
WINSTON SALEM, NC 27127
Dentist (General Practice)
2101 PETERS CREEK PKWY
WINSTON SALEM, NC 27127

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1568892016, enumerated as an "individual" on November 20, 2013.

The provider is located at 2101 PETERS CREEK PKWY SUITE 20-22 WINSTON SALEM, NC 27127 and the phone number is (336) 761-5300.

Social Worker with taxonomy code 1041C0700X and a focus in Clinical.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Group Health. Please consult your insurance carrier or call the provider to verify.