JEANIE RAY SHADE LCSW
NPI 1659048809
Social Worker - Clinical in Bentonville, AR

Active since August 25, 2021PECOS EnrolledAccepts Medicare Assignment
1001 SE 28TH ST, BENTONVILLE, AR 72712(479) 403-2915 Get Directions Write a Review

NPPES record last updated: December 6, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 6, 2023, Aug 25, 2021 (2 updates tracked since 2021).

About Jeanie Ray Shade Lcsw NPPES

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

JEANIE RAY SHADE LCSW (NPI 1659048809) is an individual clinical provider in Bentonville, Arkansas, licensed in Arkansas (12579-C) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1659048809
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameJEANIE RAY SHADECredential: LCSW
Location Address1001 SE 28TH STBentonville, AR 72712-3205
Mailing Address53 Nantucket DrBella Vista, AR 72715-8178 · (208) 749-4323
Sole ProprietorYes
Medical School CMSOtherGraduated 2010
Enumeration DateAugust 25, 2021
Last NPPES UpdateDecember 6, 20232 updates tracked since enumeration
NPPES CertifiedDecember 6, 2023
NPI 1659048809 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 AR · 12579-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.

1001 SE 28TH ST, Bentonville, AR 72712

Accepted 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

Jeanie Ray Shade 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 ID3577071067
PECOS Enrollment IDI20250805003128
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 72712 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 $51.36 – $157.74
Typical copayment $0.00 (range $12.84 – $39.43)
Most-billed visit code NA
Established Patient
$64.56 typical visit price
range $16.16 – $128.77
Typical copayment $16.14 (range $4.04 – $32.19)
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 6

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

Counselor (Mental Health)
1001 SE 28TH ST
BENTONVILLE, AR 72712
Dentist
1001 SE 28TH ST, STE 7
BENTONVILLE, AR 72712
Case Manager/Care Coordinator
1001 SE 28TH ST
BENTONVILLE, AR 72712
Case Manager/Care Coordinator
1001 SE 28TH ST
BENTONVILLE, AR 72712
Case Manager/Care Coordinator
1001 SE 28TH ST
BENTONVILLE, AR 72712
Case Manager/Care Coordinator
1001 SE 28TH ST
BENTONVILLE, AR 72712

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 Jeanie Shade's NPI number?

The NPI number for Jeanie Shade is 1659048809. It was assigned to this individual provider in the NPPES registry on August 25, 2021.

Where is Jeanie Shade located?

Jeanie Shade practices at 1001 SE 28th St, Bentonville, AR 72712. The listed phone number is (479) 403-2915.

What is Jeanie Shade's specialty?

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

Is Jeanie Shade enrolled in Medicare?

Yes. Jeanie Shade is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jeanie Shade accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 6 other insurers list Jeanie Shade 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 Jeanie Shade was last updated on December 6, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.