Active NPI
Shannon Marie Nelson, LSW
- Social Worker
- Williamsport, PA
National Provider Identifier
1003691056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SW140500
- Practice address
- 705 Washington Blvd Ste 100
Williamsport, PA 17701-5355 - Phone
- (570) 321-6390
- NPI assigned
- Aug 29, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | SW140500 | PA | Primary |
Addresses
Primary practice location
705 Washington Blvd Ste 100
Williamsport, PA 17701-5355
Mailing address
32 Hillcrest LN
Williamsport, PA 17701-9603
Phone (484) 788-9775
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW140500 | PA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693267200000",
"number": "1003691056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 HILLCREST LN",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177019603",
"telephone_number": "484-788-9775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 WASHINGTON BLVD STE 100",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177015355",
"telephone_number": "570-321-6390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "SHANNON",
"middle_name": "MARIE",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-29",
"last_updated": "2023-08-29",
"certification_date": "2023-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "PA",
"license": "SW140500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamsport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.