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SHANNON BROCK LCSWR
NPI 1639362635
Social Worker - Clinical in Fort Edward, NY

Active since August 22, 2007PECOS Enrolled
46 REYNOLDS RD, FORT EDWARD, NY 12828(518) 573-0239(518) 747-2194 Get Directions Write a Review

NPPES record last updated: November 21, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Nov 21, 2025, Jun 15, 2018 (2 updates tracked since 2018).

About Shannon Brock Lcswr NPPES

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

SHANNON BROCK LCSWR (NPI 1639362635) is an individual clinical provider in Fort Edward, New York, licensed in New York (078314) and active in the NPI registry since August 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639362635
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSHANNON BROCKCredential: LCSWR
Location Address46 REYNOLDS RDFort Edward, NY 12828-9217
Mailing Address46 Reynolds RdFort Edward, NY 12828-9217 · (518) 573-0239 · Fax (518) 747-2194
Phone(518) 573-0239
Fax(518) 747-2194
Sole ProprietorNo
Enumeration DateAugust 22, 2007
Last NPPES UpdateNovember 21, 20252 updates tracked since enumeration
NPPES CertifiedNovember 21, 2025
✔ NPI 1639362635 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 NY · 078314
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.
46 REYNOLDS RD, Fort Edward, NY 12828
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannon Brock Lcswr 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 12828 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 $54.87 – $166.88
Typical copayment $0.00 (range $13.71 – $41.72)
Most-billed visit code NA
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
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 8

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

MUBARIKA SAKINA MIRZA LMSW
Social Worker
46 REYNOLDS RD
FORT EDWARD, NY 12828
Washington County (518) 573-0239
SMBM, LCSW, PLLC
Community/Behavioral Health
46 REYNOLDS RD
FORT EDWARD, NY 12828
Washington County (518) 573-0239
STEPHANIE ANN RAILEY LMSW
Social Worker
46 REYNOLDS RD
FORT EDWARD, NY 12828
Washington County (518) 573-0239
PAMELA JEAN LUNZ MEDINA
Social Worker (Clinical)
46 REYNOLDS RD
FORT EDWARD, NY 12828
Washington County (518) 573-0239
LAUREL GREEN LMSW
Social Worker
46 REYNOLDS RD
FORT EDWARD, NY 12828
Washington County (518) 316-9440
KIRSTEN SPERO
Social Worker
46 REYNOLDS RD
FORT EDWARD, NY 12828
Washington County (518) 573-0239
MOLLY MADDEN LMSW
Social Worker
46 REYNOLDS RD
FORT EDWARD, NY 12828
Washington County (518) 573-0239
STACY LYNN ROGERS
Social Worker
46 REYNOLDS RD
FORT EDWARD, NY 12828
Washington County (518) 573-0239

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 Brock's NPI number?

The NPI number for Shannon Brock is 1639362635. It was assigned to this individual provider in the NPPES registry on August 22, 2007.

Where is Shannon Brock located?

Shannon Brock practices at 46 Reynolds Rd, Fort Edward, NY 12828. The listed phone number is (518) 573-0239.

What is Shannon Brock's specialty?

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

Is Shannon Brock enrolled in Medicare?

Yes. Shannon Brock is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Shannon Brock was last updated on November 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.