Shannon Charles, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

44SL05652700 Issued in NJ

Practice address

619 S Marion Ave
Lake City, FL 32025-5808

Phone

(973) 941-8322

NPI assigned

Jul 23, 2013

Last updated

Dec 9, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• S.C. Healing Haven

  • Clinical Social Worker
  • Millburn, NJ
  • NPI 1235934084
  NPD Authorized official

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1053753848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 NW 39TH RD",
            "address_2": "#309",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072322",
            "telephone_number": "973-941-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255808",
            "telephone_number": "973-941-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "SHANNON",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05652700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Elaine Chapman, MED.,CCC-SLP
• Vanessa Sharon Chappell, LCSW
• David Charles Charland, P.T.
• Charles C Greene MD PHD PA (Jacksonville ENT Surgery Center)
• Charles Varghese M D
• Cara Chatmon
• Cheek & Scott Drugs Inc
• Jerry Hamilton Cheesman, D.M.D.
• Arleen Cheetham, RPH
• Mariah Cheevers, APRN

• Social Worker in Lake City, FL
• Providers in Lake City, FL by specialty
• Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; 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.