Active NPI
Jan Eilene Shaughnessy, LCSW
- Clinical Social Worker
- Boise, ID
National Provider Identifier
1043480692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW27207
- Practice address
- 226 S Cole Rd
Boise, ID 83709-0934 - Phone
- (208) 376-3677
- Fax
- (208) 376-3730
- NPI assigned
- Mar 10, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW27207 | ID | Primary |
Addresses
Primary practice location
226 S Cole Rd
Boise, ID 83709-0934
Mailing address
226 S. Cole Rd
Boise, ID 83709
Phone (208) 376-3677
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 |
|---|---|---|---|
| LCSW27207 | ID | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336089600000",
"number": "1043480692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "226 S. COLE RD",
"city": "BOISE",
"state": "ID",
"postal_code": "83709",
"telephone_number": "208-376-3677",
"fax_number": "208-376-3730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "226 S COLE RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837090934",
"telephone_number": "208-376-3677",
"fax_number": "208-376-3730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAUGHNESSY",
"first_name": "JAN",
"middle_name": "EILENE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-10",
"last_updated": "2012-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW27207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.