Individual provider Active NPI

Shawn R Slater, LCSW

  • Clinical Social Worker
  • Pahoa, HI
National Provider Identifier
1003947250
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3331 Issued in HI
Practice address
14-803 Seaview Rd
Nanawale Estates
Pahoa, HI 96778-1341
Phone
(808) 965-5349
Fax
(808) 965-5036
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3331 HI Primary

Addresses

Primary practice location

14-803 Seaview Rd
Nanawale Estates
Pahoa, HI 96778-1341

Mailing address

PO Box 1341
14-803 Seaview Rd
Pahoa, HI 96778-1341
Phone (808) 965-5349

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3331HIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003947250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1341",
            "address_2": "14-803 SEAVIEW RD",
            "city": "PAHOA",
            "state": "HI",
            "postal_code": "967781341",
            "telephone_number": "808-965-5349",
            "fax_number": "808-965-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14-803 SEAVIEW RD",
            "address_2": "NANAWALE ESTATES",
            "city": "PAHOA",
            "state": "HI",
            "postal_code": "967781341",
            "telephone_number": "808-965-5349",
            "fax_number": "808-965-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATER",
        "first_name": "SHAWN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "3331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pahoa, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.