Individual provider Active NPI

Albert A Shigo, LICSW PHD

  • Clinical Social Worker
  • Derry, NH
National Provider Identifier
1053489732
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
107 Issued in NH
Practice address
6 Londonderry Road
Derry, NH 03038
Phone
(603) 370-0972
Fax
(603) 382-0386
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 107 NH Primary
Clinical Social Worker 1041C0700X 106093 MA

Addresses

Primary practice location

6 Londonderry Road
Derry, NH 03038

Mailing address

2 Village Green Rd
Ste BS
Hampstead, NH 03841-5209
Phone (603) 382-4741

Other identifiers 1

IdentifierTypeStateIssuer
30420378MedicaidNH

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
106093MAMDClinical Social Worker
107NHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Counseling Associates of the Lowcountry, LLC CurrentSince Jan 21, 2013 Accepting new patients
Psychological and Counseling Center PastSince Jan 21, 2013 Accepting new patients

Locations

23 Plantation Park Dr
Ste 202
Bluffton, SC 29910
Phone (843) 290-6828

102 Buckwalter Pkwy
Ste 3UV
Bluffton, SC 29910
Phone (843) 290-6828

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1053489732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 VILLAGE GREEN RD",
            "address_2": "STE BS",
            "city": "HAMPSTEAD",
            "state": "NH",
            "postal_code": "038415209",
            "telephone_number": "603-382-4741",
            "fax_number": "603-329-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 LONDONDERRY ROAD",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "03038",
            "telephone_number": "603-370-0972",
            "fax_number": "603-382-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIGO",
        "first_name": "ALBERT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "LICSW PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "107",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106093",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30420378",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.