Individual provider Active NPI

Shirley Reich, LCSW

  • Clinical Social Worker
  • Maynard, MA
National Provider Identifier
1063778199
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11429-C Issued in NV
Practice address
141 Parker St Ste 306
Maynard, MA 01754-2180
Phone
(866) 991-2103
NPI assigned
Apr 3, 2012
Last updated
Sep 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 63739 CA
Clinical Social Worker 1041C0700X 11429-C NV Primary

Addresses

Primary practice location

141 Parker St Ste 306
Maynard, MA 01754-2180

Mailing address

3558 Winter Scene CT
Las Vegas, NV 89147-3718
Phone (323) 497-0314

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20240603002443 NV Practitioner - Clinical Social Worker 1658685201 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63739CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oasis Counseling LLC CurrentSince Apr 26, 2024 Accepting new patients

Locations

2360 W Horizon Ridge Pkwy
Ste 120
Henderson, NV 89052
Phone (702) 518-7629

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1333411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1063778199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3558 WINTER SCENE CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891473718",
            "telephone_number": "323-497-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 PARKER ST STE 306",
            "city": "MAYNARD",
            "state": "MA",
            "postal_code": "017542180",
            "telephone_number": "866-991-2103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICH",
        "first_name": "SHIRLEY",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-03",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "63739",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "11429-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maynard, MA

Sources for this page

Verify at the official NPI Registry.