MR. SHAWN ROBERT ISRAELSEN LCSW
NPI 1629679048
Counselor - Professional in Idaho Falls, ID

Q: What is Shawn Israelsen's NPI number?

The NPI number for Shawn Israelsen is 1629679048. It was assigned to this individual provider in the NPPES registry on November 3, 2020.

Q: What is Shawn Israelsen's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Shawn Israelsen was last updated on October 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since November 03, 2020PECOS EnrolledAccepts Medicare Assignment

2265 W BROADWAY ST, IDAHO FALLS, ID 83402(208) 524-7400(208) 534-8004 Get Directions Write a Review

NPPES record last updated: October 18, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 18, 2023, Aug 9, 2022, Nov 3, 2020 (3 updates tracked since 2020).

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About Mr. Shawn Robert Israelsen Lcsw NPPES

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

MR. SHAWN ROBERT ISRAELSEN LCSW (NPI 1629679048) is an individual professional provider in Idaho Falls, Idaho, licensed in Idaho (LCSW-44276) and active in the NPI registry since November 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1629679048

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMR. SHAWN ROBERT ISRAELSENCredential: LCSW

Location Address2265 W BROADWAY STIdaho Falls, ID 83402-2996

Mailing Address2275 W. Broadway St #gIdaho Falls, ID 83402-2902 · (208) 524-7400 · Fax (208) 524-8004

Phone(208) 524-7400

Fax(208) 534-8004

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateNovember 3, 2020

Last NPPES UpdateOctober 18, 20233 updates tracked since enumeration

NPPES CertifiedOctober 18, 2023

✔ NPI 1629679048 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in ID · LCSW-44276

Also ListedSocial WorkerTaxonomy 104100000X · License LMSW-18733 (AZ), LMSW-40331 (ID)

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 8722060-3502 (UT), 8722060-3502CSW (UT)

2265 W BROADWAY ST, Idaho Falls, ID 83402

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., University of Utah Health Plans.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Shawn Robert Israelsen Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7214386473

PECOS Enrollment IDI20231213001395

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 20

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

LIZA PAIGE HANSEN LCSW

Social Worker