Active NPI
Shanelle Nicole McClaine, LCSW
- Clinical Social Worker
- Glade Hill, VA
National Provider Identifier
1063748564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904008639
- Practice address
- 200 Waterfront Rd
Glade Hill, VA 24092-1843 - Phone
- (229) 588-6015
- NPI assigned
- Oct 19, 2009
- Last updated
- Jun 2, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904008639 | VA | Primary |
Addresses
Primary practice location
200 Waterfront Rd
Glade Hill, VA 24092-1843
Mailing address
200 Waterfront Rd
Glade Hill, VA 24092-1843
Phone (229) 588-6015
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, DC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904008639 | VA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inner Balance, PLLC | Clinical | Current | Accepting new patients |
| Grow Healthcare Group PA | Clinical | Current | Accepting new patients |
| My Psychiatrist LLC | Past | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598
Organizations & group practices 3
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.
-
dba My Psychiatrist PLC
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Reston, VA
- NPI 1295048684
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748822400000",
"number": "1063748564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 WATERFRONT RD",
"city": "GLADE HILL",
"state": "VA",
"postal_code": "240921843",
"telephone_number": "229-588-6015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 WATERFRONT RD",
"city": "GLADE HILL",
"state": "VA",
"postal_code": "240921843",
"telephone_number": "229-588-6015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLAINE",
"first_name": "SHANELLE",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-19",
"last_updated": "2025-06-02",
"certification_date": "2025-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904008639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glade Hill, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; 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.