Shadan A Sirwan

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11476-123 Issued in WI

Practice address

7322 W Rawson Ave
Franklin, WI 53132-8117

Phone

(414) 292-4242

Fax

(262) 240-9745

NPI assigned

Jun 6, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shadan A Fuqe Former name

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": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700352000000",
    "number": "1023747169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8560 W WATERFORD AVE APT 6",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532282328",
            "telephone_number": "206-495-7614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7322 W RAWSON AVE",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531328117",
            "telephone_number": "414-292-4242",
            "fax_number": "262-240-9745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRWAN",
        "first_name": "SHADAN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-06",
        "last_updated": "2023-11-19",
        "certification_date": "2023-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11476-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHADAN",
            "last_name": "FUQE",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joseph Ronald Simon
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• Blama Sirleaf, BSN, RN
• Steven Richard Sirus, MD
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• Emily Jane Skibinski, DDS
• Kathleen Slawianowski, LPC
• Sleep Health Wisconsin LLC

• Clinical Social Worker in Franklin, WI
• Providers in Franklin, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.

Verify at the official NPI Registry.