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SHANNON LEE KOSSICK LCSW, LCADC
NPI 1619639762
Social Worker - Clinical in Carson City, NV

Active since October 06, 2021Opted out of Medicare · through Jun 5, 2027
777 E WILLIAM ST STE 108, CARSON CITY, NV 89701(775) 400-2660 Get Directions Write a Review

NPPES record last updated: March 22, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 22, 2026, Aug 17, 2023, Aug 8, 2023 and 3 more (6 updates tracked since 2021).

About Shannon Lee Kossick Lcsw, Lcadc NPPES

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

SHANNON LEE KOSSICK LCSW, LCADC (NPI 1619639762) is an individual clinical provider in Carson City, Nevada, licensed in Nevada (11331-C) and active in the NPI registry since October 2021. She has opted out of Medicare through June 5, 2027.

NPPES Registry Identity

NPI1619639762
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSHANNON LEE KOSSICKCredential: LCSW, LCADC
Location Address777 E WILLIAM ST STE 108Carson City, NV 89701-4057
Mailing Address1944 Molly DrCarson City, NV 89706-2643 · (916) 751-9899
Phone(775) 400-2660
Sole ProprietorNo
Enumeration DateOctober 6, 2021
Last NPPES UpdateMarch 22, 20266 updates tracked since enumeration
NPPES CertifiedMarch 22, 2026
✔ NPI 1619639762 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NV · 11331-C
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.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 08156-LC (NV)
777 E WILLIAM ST STE 108, Carson City, NV 89701
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Shannon Lee Kossick Lcsw, Lcadc 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 June 5, 2025 through June 5, 2027.

Opt-Out Effective DateJune 5, 2025
Opt-Out In Effect ThroughJune 5, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

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

THE MINDFUL GOLDFISH LLC
Social Worker (Clinical)
777 E WILLIAM ST STE 108
CARSON CITY, NV 89701
Carson City (775) 400-2660

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 Kossick's NPI number?

The NPI number for Shannon Kossick is 1619639762. It was assigned to this individual provider in the NPPES registry on October 6, 2021.

Where is Shannon Kossick located?

Shannon Kossick practices at 777 E William St Ste 108, Carson City, NV 89701. The listed phone number is (775) 400-2660.

What is Shannon Kossick's specialty?

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

Is Shannon Kossick enrolled in Medicare?

No. Shannon Kossick has opted out of Medicare through June 5, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Shannon Kossick was last updated on March 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.