MRS. SHANNON EASTER KELLEY LISW
NPI 1871806968
Social Worker in Willoughby, OH

Q: What is Shannon Easter Kelley's NPI number?

The NPI number for Shannon Easter Kelley is 1871806968. It was assigned to this individual provider in the NPPES registry on July 19, 2010.

Q: What is Shannon Easter Kelley's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Active since July 19, 2010PECOS Enrolled

38882 MENTOR AVE, WILLOUGHBY, OH 44094(440) 953-9999(440) 918-3839 Get Directions Write a Review

NPPES record last updated: June 4, 2019. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Mrs. Shannon Easter Kelley Lisw NPPES

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

MRS. SHANNON EASTER KELLEY LISW (NPI 1871806968) is an individual social worker in Willoughby, Ohio and active in the NPI registry since July 2010. She is enrolled in Medicare PECOS and maintains a secondary practice location in Willoughby.

NPPES Registry Identity

NPI1871806968

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameMRS. SHANNON EASTER KELLEYCredential: LISW

Location Address38882 MENTOR AVEWilloughby, OH 44094

Mailing Address38882 Mentor AveWilloughby, OH 44094-7875 · (440) 953-9999 · Fax (440) 918-3839

Phone(440) 953-9999

Fax(440) 918-3839

Sole ProprietorNo

Enumeration DateJuly 19, 2010

Last NPPES UpdateJune 4, 2019

✔ NPI 1871806968 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

38882 MENTOR AVE, Willoughby, OH 44094

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Secondary Practice Location 1

Location 138882 Mentor AveWilloughby, OH 44094 · Phone (440) 953-9999 ext. 19166 · Fax (440) 918-3839

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Shannon Easter Kelley Lisw 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.

Medicare Billing Reassignment

Medicare enrollment records show Shannon Easter Kelley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Signature Health, Inc

Same address

Mental Health (Including Community Mental Health Center)

38876 MENTOR AVE
Willoughby, OH 44094

Reassigned Medicare billing, Ohio enrollment
342 clinicians in this Medicare group

NPI 1477575348 (440) 953-9999

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

KRYSTI CAMPLESE

Case Manager/Care Coordinator