Shannon Leah Hendrickson, PSY.D.
NPI 1629510169ActiveIndividual· Psychologist, Clinical· Surprise, AZ
Opted out of Medicare from April 2026 to April 2028. Psychologist, Clinical (PSY.D.) in Surprise, Arizona, licensed in AZ, with an NPI issued in November 2016.
Overview
| NPI | 1629510169 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSY.D. |
| Sole proprietor | No |
| NPI issued | Nov 15, 2016 |
| Last updated in NPPES | Aug 25, 2025 |
| Certified by provider | Aug 25, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | 4779 | AZ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|---|
| Opt-out | Opted out Apr 1, 2026 – Apr 1, 2028 |
| Can order and refer | No |
During an opt-out period the provider sees Medicare patients only under private contracts, and Medicare does not pay claims for their services.
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