Donna L Shock, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3953 Issued in HI

Practice address

78-123 Holuakai St
Kailua Kona, HI 96740-2596

Phone

(808) 365-2536

NPI assigned

Jun 9, 2012

Sex

Female

Sole proprietor

Yes

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

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellness Partners Hawaii IncGroup PAC ID 4183018559, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Wellness Partners Hawaii Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Honolulu, HI
  • NPI 1609382340
  Medicare reassignment Care Compare group NPD
• Wellness Partners Hawaii PHP and Iop, LLC

  • Community/Behavioral Health Agency
  • Honolulu, HI
  • NPI 1033953922
  NPD (past)

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

{
    "created_epoch": "1339200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652486400000",
    "number": "1053673756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78-123 HOLUAKAI ST",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402596",
            "telephone_number": "808-365-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78-123 HOLUAKAI ST",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402596",
            "telephone_number": "808-365-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCK",
        "first_name": "DONNA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-09",
        "last_updated": "2022-05-14",
        "certification_date": "2022-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "1210",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "3953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Irene Shaver, LMFT
• Kelly P Shaw
• Stacey Shepard, L.AC.
• Junko N Shields
• Bret Shimizu, L.AC.
• Nathan Frank Shove, CSFA
• Silversage Physician Services of Hawaii, Professional Corporation
• Michelle Corpuz Serrano Simpson, LCSW
• Julie Lynn Sims, LCSW
• Alyssa Rose Skinner

• Clinical Social Worker in Kailua Kona, HI
• Providers in Kailua Kona, HI by specialty
• Clinical Social Worker in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.