Jeff Shively, LICSW
NPI 1376782961 · Clinical Social Worker · Plymouth, MN
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jeff Shively, LICSW is a Clinical Social Worker provider in Plymouth, MN (NPI 1376782961).
Provider details
- NPI number
- 1376782961
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LICSW
- Sex
- Male
- Sole proprietor
- No
- License
- 18053 (MN)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2009-02-05
- Last updated
- 2013-03-05
Frequently asked questions
- What is Jeff Shively's NPI number?
- Jeff Shively's National Provider Identifier (NPI) is 1376782961, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jeff Shively's specialty?
- Jeff Shively is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Jeff Shively located?
- Jeff Shively's practice location on file with NPPES is 12805 Highway 55, Plymouth, MN 55441-3859.
- What is Jeff Shively's phone number?
- The practice phone number listed in the NPPES registry for Jeff Shively is (612) 723-0408.
- Does Jeff Shively accept Medicare?
- Jeff Shively is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jeff Shively's NPI active?
- Yes — Jeff Shively's NPI (1376782961) is active in the NPPES registry as of the last update on 2013-03-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.