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

Active since November 20, 2013Opted out of Medicare · through Oct 1, 2027
2101 PETERS CREEK PKWY, SUITE 20-22, WINSTON SALEM, NC 27127(336) 761-5300(336) 761-5319 Get Directions Write a Review

NPPES record last updated: November 20, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Shannon Kostuck Msw, Lcsw-a NPPES

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

MRS. SHANNON KOSTUCK MSW, LCSW-A (NPI 1568892016) is an individual clinical provider in Winston Salem, North Carolina, licensed in North Carolina (P007907) and active in the NPI registry since November 2013. She has opted out of Medicare through October 1, 2027.

NPPES Registry Identity

NPI1568892016
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. SHANNON KOSTUCKCredential: MSW, LCSW-A
Location Address2101 PETERS CREEK PKWY, SUITE 20-22Winston Salem, NC 27127-3726
Mailing Address2101 Peters Creek Pkwy, Suite 20-22Winston Salem, NC 27127-3726 · (336) 761-5300 · Fax (336) 761-5319
Phone(336) 761-5300
Fax(336) 761-5319
Sole ProprietorNo
Enumeration DateNovember 20, 2013
✔ NPI 1568892016 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 NC · P007907
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.
2101 PETERS CREEK PKWY, Winston Salem, NC 27127
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Group Health Cooperative-SCW, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Shannon Kostuck Msw, Lcsw-a has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2025 through October 1, 2027.

Opt-Out Effective DateOctober 1, 2025
Opt-Out In Effect ThroughOctober 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 6

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

MR. CHRISTOPHER SHANE GEORGEFF PA-C
Physician Assistant (Medical)
2101 PETERS CREEK PKWY
WINSTON SALEM, NC 27127
Forsyth County (336) 955-1379
SOUTHSIDE UNITED HEALTH CENTERS
Dentist
2101 PETERS CREEK PKWY
WINSTON SALEM, NC 27127
Forsyth County (336) 955-1379
DR. ANNIE CLARK
Dentist (General Practice)
2101 PETERS CREEK PKWY
WINSTON SALEM, NC 27127
Forsyth County (336) 955-1379
DR. SADEGH SALEKNEZHAD MD
Internal Medicine
2101 PETERS CREEK PKWY
WINSTON SALEM, NC 27127
Forsyth County (336) 955-1379
KARINA MARTINEZ
Social Worker (Clinical)
2101 PETERS CREEK PKWY
WINSTON SALEM, NC 27127
Forsyth County (336) 955-1379
DR. CASEY REYNOLDS DDS
Dentist (Dental Public Health)
2101 PETERS CREEK PKWY
WINSTON SALEM, NC 27127
Forsyth County (336) 955-1379

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 Kostuck's NPI number?

The NPI number for Shannon Kostuck is 1568892016. It was assigned to this individual provider in the NPPES registry on November 20, 2013.

Where is Shannon Kostuck located?

Shannon Kostuck practices at 2101 Peters Creek Pkwy Suite 20-22, Winston Salem, NC 27127. The listed phone number is (336) 761-5300.

What is Shannon Kostuck's specialty?

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

Is Shannon Kostuck enrolled in Medicare?

No. Shannon Kostuck has opted out of Medicare through October 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Shannon Kostuck accept?

Health plans from Anthem Blue Cross and Blue Shield, Group Health Cooperative-SCW, Providence Health Plan and Quartz list Shannon Kostuck 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 Kostuck was last updated on November 20, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.