Individual provider Active NPI

Shayna Warner, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1053936302
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2020000398 Issued in MO
Practice address
12141 Ladue Rd
Saint Louis, MO 63141-8120
Phone
(314) 878-4340
Fax
(314) 878-4524
NPI assigned
Jun 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2020000398 MO Primary

Addresses

Primary practice location

12141 Ladue Rd
Saint Louis, MO 63141-8120

Mailing address

12141 Ladue Rd
Saint Louis, MO 63141-8120
Phone (314) 878-4340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20200721003450 MO Practitioner - Clinical Social Worker 3678997897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sonder Counseling LLCGroup PAC ID 9133524788, 10 clinicians

Practice addresses (Care Compare)

230 S Bemiston Ave
Suite 1006
Clayton, MO 63105-1907
Phone (314) 925-2634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2020000398MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sonder Counseling LLC CurrentSince Aug 2, 2022 Accepting new patients

Locations

230 S Bemiston Ave
Ste 1006
Saint Louis, MO 63105
Phone (314) 925-2634

Organizations & group practices 1

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": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1053936302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12141 LADUE RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418120",
            "telephone_number": "314-878-4340",
            "fax_number": "314-878-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12141 LADUE RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418120",
            "telephone_number": "314-878-4340",
            "fax_number": "314-878-4524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER",
        "first_name": "SHAYNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-12",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2020000398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.