Shannon Clymer, LCSW77167

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW77167 Issued in CA

Practice address

2060 Campus Dr
Yreka, CA 96097-9538

Phone

(530) 841-4100

NPI assigned

Dec 18, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1033530951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 CAMPUS DR",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960979538",
            "telephone_number": "530-841-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 CAMPUS DR",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960979538",
            "telephone_number": "530-841-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYMER",
        "first_name": "SHANNON",
        "credential": "LCSW77167",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-18",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "ASW35650",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW77167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Cheula
• Anna Nicole Christie
• Nancy Ann Christie
• Mario Cintron
• Kendall Clymer
• Amy Marie Coapman, FNP
• Tyler Coelho-Herrera
• Sarah Gates Collard, PH.D.
• Diana Lee Collier
• Kara Collier

• Clinical Social Worker in Yreka, CA
• Providers in Yreka, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; 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.