Shawn Harris Muthersbaugh, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R032125 Issued in NY

Practice address

120 Defreest Dr.,
175
Troy, NY 12180

Phone

(518) 390-6890

Fax

(518) 374-6898

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

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.

• Shawn Muthersbaugh LCSW PLLC

  • Community/Behavioral Health Agency
  • Troy, NY
  • NPI 1407462948
  NPD Authorized official
• Anova Medical Supply, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Albany, NY
  • NPI 1184650574
  NPD (past)
• Cca Wellness Network Ipa LLC

  • Counselor
  • Delmar, NY
  • NPI 1992468813

  Clinical

  NPD (past)

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1063404143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 DEFREEST DR.,",
            "address_2": "175",
            "city": "TROY",
            "state": "NY",
            "postal_code": "12180",
            "telephone_number": "518-390-6890",
            "fax_number": "518-374-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 DEFREEST DR.,",
            "address_2": "175",
            "city": "TROY",
            "state": "NY",
            "postal_code": "12180",
            "telephone_number": "518-390-6890",
            "fax_number": "518-374-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTHERSBAUGH",
        "first_name": "SHAWN",
        "middle_name": "HARRIS",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "R032125",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R032125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01645743",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorothy Louise Murray, M.S.
• Judith Lynn Murray, CASAC
• Toshiia Murray
• Colleen Margaret Murtagh, CNM
• Ronald Musto
• Anaquel Raquel Mwapaga, FNP
• Ngozi Mwosu
• Austin Myers, RPH
• Matthew Myers, DPT
• Henrietta Nagy, OTR/L

• Clinical Social Worker in Troy, NY
• Providers in Troy, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.