NPIMap

Organization Active NPI

Shirley Claassen Dick LLC

  • Clinical Social Worker
  • Goshen, IN
National Provider Identifier
1104299783
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34001401A Issued in IN
Legal business name
SHIRLEY CLAASSEN DICK LLC
Practice address
1930 W Lincoln Ave
Goshen, IN 46526-5907
Phone
(574) 534-2161
NPI assigned
Nov 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Authorized official

Name
Shirley Claassen Dick
Title
Sole Member
Phone
(574) 238-5842

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 34001401A IN Primary

Addresses

Primary practice location

1930 W Lincoln Ave
Goshen, IN 46526-5907

Mailing address

1930 W Lincoln Ave
Goshen, IN 46526-5907
Phone (574) 534-2161

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446595200000",
    "number": "1104299783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 W LINCOLN AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465265907",
            "telephone_number": "574-534-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 W LINCOLN AVE",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465265907",
            "telephone_number": "574-534-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIRLEY CLAASSEN DICK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A",
        "authorized_official_last_name": "DICK",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "CLAASSEN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "574-238-5842"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34001401A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; 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.