Jeff William Shively, LICSW - Clinical Social Worker in Plymouth, MN

Jeff William Shively, LICSW is a Social Worker - Clinical based in Plymouth, Minnesota. Jeff William Shively is licensed to practice in Minnesota (license number 18053) and his current practice location is 12805 Highway 55, Suite 200, Plymouth, Minnesota. He can be reached at his office (for appointments etc.) via phone at (612) 723-0408.

NPI number for Jeff William Shively is 1376782961 and his current mailing address is 12805 Highway 55, Suite 200, Plymouth, Minnesota. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1376782961.

Contact Information

Jeff William Shively, LICSW
12805 Highway 55, Suite 200,
Plymouth, MN 55441-3859
(612) 723-0408
(763) 210-5379

Map and Direction




Healthcare Provider's Profile

Full NameJeff William Shively
GenderMale
SpecialitySocial Worker - Clinical
Location12805 Highway 55, Plymouth, Minnesota
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1376782961
  • Provider Enumeration Date: 02/05/2009
  • Last Update Date: 03/05/2013

Medical Identifiers

Medical identifiers for Jeff William Shively such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1376782961NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical 18053 (Minnesota)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jeff William Shively is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jeff William Shively, LICSW
12805 Highway 55, Suite 200,
Plymouth, MN 55441-3859

Ph: (612) 723-0408
Jeff William Shively, LICSW
12805 Highway 55, Suite 200,
Plymouth, MN 55441-3859

Ph: (612) 723-0408

Reviews and Comments


Social Worker in Plymouth, MN

Yolonda Yvette Rogers, LICSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 2415 Upland Ln N Unit A, Plymouth, MN 55447
Phone: 612-385-0991    
Megan Hickenbottom, LICSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 2855 Campus Dr, Plymouth, MN 55441
Phone: 763-577-7000    
Ying P Elliott, LICSW
Clinical Social Worker
Medicare: May Accept Medicare Assignments
Practice Location: 10700 Old County Road 15 Ste 170, Plymouth, MN 55441
Phone: 763-525-8590    Fax: 763-525-8592
Jamie Schley,
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 9800 Rockford Rd, Suite 100, Plymouth, MN 55442
Phone: 952-460-9045    
Laura Michelle Groeneweg, MSW, LICSW
Clinical Social Worker
Medicare: Medicare Enrolled
Practice Location: 3033 Campus Dr Ste E180, Plymouth, MN 55441
Phone: 524-609-0869    Fax: 763-416-0916
Deirdra Lynn Hoolahan,
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 13110 37th Ave N, Plymouth, MN 55441
Phone: 612-386-2661    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.