Individual provider Active NPI

Shannon Emerick, LCSW

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1033471495
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C005813 Issued in NC
Practice address
1057B Bullard CT
Raleigh, NC 27615-6801
Phone
(919) 270-7078
NPI assigned
Jun 12, 2012
Last updated
Jun 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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 C005813 NC Primary

Addresses

Primary practice location

1057B Bullard CT
Raleigh, NC 27615-6801

Mailing address

1512 Knots LNDG
Garner, NC 27529-9755
Phone (919) 270-7078

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

LicenseStateTypeSpecialty
C005813NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1033471495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 KNOTS LNDG",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275299755",
            "telephone_number": "919-270-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057B BULLARD CT",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156801",
            "telephone_number": "919-270-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMERICK",
        "first_name": "SHANNON",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.