Individual ProviderShanna LindstromSocial WorkerBehavioral Health & Social Service ProvidersPractice Address5965 S 900 E, Salt Lake City, UT 84121-1720(801) 263-7138PECOS EnrollmentBased on the most recent information from CMS, provider Shanna Lindstrom is legally eligible to order and refer claims for DME services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1770915712Provider TypeIndividualFull NameLindstrom, ShannaTitleMrs.CredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date8/1/2013Last Updated8/19/2015Contact InformationPractice LocationPractice Address5965 S 900 E, Salt Lake City, UT 84121-1720Phone(801) 263-7138FaxUnlisted FaxMailing LocationMailing Address5965 S 900 E, Salt Lake City, UT 84121-1720Phone(801) 263-7138FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense8603746-3502Utah