Ryan Shook, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10681 Issued in CT

Practice address

147 Durham Rd
Madison, CT 06443-2675

Phone

(860) 238-3632

NPI assigned

Jan 20, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1003187196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 DURHAM RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432675",
            "telephone_number": "860-238-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 DURHAM RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432675",
            "telephone_number": "860-238-3632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Elm St",
            "address_purpose": "LOCATION",
            "city": "Old Saybrook",
            "state": "CT",
            "postal_code": "064754105",
            "country_code": "US",
            "telephone_number": "860-744-9780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOOK",
        "first_name": "RYAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-20",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "10681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Madison, CT
• Providers in Madison, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.