Shamen Radcliffe, EDD, MA, MSW, MA

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1707 Tatum St Apt 1
Falcon Heights, MN 55113-5527

Phone

(651) 412-7260

NPI assigned

Oct 12, 2023

Sex

Male

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

Credentials

Master of Arts

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1093596280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 TATUM ST APT 1",
            "city": "FALCON HEIGHTS",
            "state": "MN",
            "postal_code": "551135527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 TATUM ST APT 1",
            "city": "FALCON HEIGHTS",
            "state": "MN",
            "postal_code": "551135527",
            "telephone_number": "651-412-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADCLIFFE",
        "first_name": "SHAMEN",
        "credential": "EDD, MA, MSW, MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha I Palomino Tovar
• Peace Home Healthcare LLC
• Cole William Peterson, ATC
• Donald Joseph Peterson, DDS
• Tam B Pham, D.D.S.
• Nicholas Mark Saari, DDS
• Saint Jude Hospice - Minnesota, LLC
• Samuel Schraber, DDS
• Ferencz Mihaly Vincze Turcean

• Social Worker in Falcon Heights, MN
• Providers in Falcon Heights, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; 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.