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KAIYA SHANNON LCSW
NPI 1790917987
Social Worker - Clinical in Fort Myers, FL

Active since August 20, 2009PECOS Enrolled
15901 BASS RD STE 108, FORT MYERS, FL 33908(239) 343-6050(239) 343-6051 Get Directions Write a Review

NPPES record last updated: December 2, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 2, 2020, Jan 22, 2019 (2 updates tracked since 2019).

About Kaiya Shannon Lcsw NPPES

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

KAIYA SHANNON LCSW (NPI 1790917987) is an individual clinical provider in Fort Myers, Florida, licensed in Florida (SW 9520) and active in the NPI registry since August 2009. She is enrolled in Medicare PECOS and maintains a secondary practice location in Orlando.

NPPES Registry Identity

NPI1790917987
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKAIYA SHANNONCredential: LCSW
Location Address15901 BASS RD STE 108Fort Myers, FL 33908-3838
Mailing AddressPo Box 2147Fort Myers, FL 33902-2147 · (239) 343-6050 · Fax (239) 343-6051
Phone(239) 343-6050
Fax(239) 343-6051
Sole ProprietorNo
Enumeration DateAugust 20, 2009
Last NPPES UpdateDecember 2, 20202 updates tracked since enumeration
NPPES CertifiedDecember 2, 2020
✔ NPI 1790917987 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 FL · SW 9520
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.
15901 BASS RD STE 108, Fort Myers, FL 33908
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Secondary Practice Location 1

Location 192 W Miller StOrlando, FL 32806-2032 · Phone (321) 841-7116 · Fax (321) 841-7116

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kaiya Shannon Lcsw 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 33908 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 $58.56 – $179.05
Typical copayment $0.00 (range $14.64 – $44.76)
Most-billed visit code NA
Established Patient
$73.00 typical visit price
range $18.44 – $144.68
Typical copayment $18.25 (range $4.61 – $36.17)
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 20

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

DR. DEEPA VADUTHALAKUZHY LUKA MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
15901 BASS RD STE 108
FORT MYERS, FL 33908
Lee County (239) 343-6050
DR. ERRIN E. PRICE PSY.D.
Psychologist (Clinical Child & Adolescent)
15901 BASS RD STE 108
FORT MYERS, FL 33908
Lee County (239) 343-6050
LEE MEMORIAL HEALTH SYSTEM
Clinic/Center (Federally Qualified Health Center (FQHC))
15901 BASS RD STE 108
FORT MYERS, FL 33908
Lee County (239) 343-6050
DR. RAYMOND ROBERT MAY PSY.D.
Psychologist
15901 BASS RD STE 108
FORT MYERS, FL 33908
Lee County (239) 343-6050
ALYSSA LEWIS
Clinical Nurse Specialist (Psychiatric/Mental Health, Child & Adolescent)
15901 BASS RD STE 108
FORT MYERS, FL 33908
Lee County (239) 343-9890
MS. NATALIE SMITH WILLIAMS APRN
Nurse Practitioner (Family)
15901 BASS RD STE 108
FORT MYERS, FL 33908
Lee County (239) 343-6050
DR. KRISTINA ANNE WINCHELL-BARRILE PH.D.
Psychologist
15901 BASS RD STE 108
FORT MYERS, FL 33908
Lee County (239) 343-6050
KALEESHA BENT M.S.
Marriage & Family Therapist
15901 BASS RD STE 108
FORT MYERS, FL 33908
Lee County (239) 343-6050

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 Kaiya Shannon's NPI number?

The NPI number for Kaiya Shannon is 1790917987. It was assigned to this individual provider in the NPPES registry on August 20, 2009.

Where is Kaiya Shannon located?

Kaiya Shannon practices at 15901 Bass Rd Ste 108, Fort Myers, FL 33908. The listed phone number is (239) 343-6050.

What is Kaiya Shannon's specialty?

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

Is Kaiya Shannon enrolled in Medicare?

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

What insurance does Kaiya Shannon accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Oscar Health Maintenance Organization of Florida list Kaiya Shannon 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 Kaiya Shannon was last updated on December 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.