Active NPI
Joe Shin, LMSW
- Social Worker
- Sacaton, AZ
National Provider Identifier
1104627579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LMSW-22506
- Practice address
- 483 W Seed Farm Rd
Sacaton, AZ 85147-5000 - Phone
- (602) 528-7100
- Fax
- (602) 528-1374
- NPI assigned
- Mar 21, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | LMSW-22506 | AZ | Primary |
Addresses
Primary practice location
483 W Seed Farm Rd
Sacaton, AZ 85147-5000
Mailing address
PO Box 38
Sacaton, AZ 85147-0001
Phone (602) 528-7100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-22506 | AZ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742515200000",
"number": "1104627579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 38",
"city": "SACATON",
"state": "AZ",
"postal_code": "851470001",
"telephone_number": "602-528-7100",
"fax_number": "602-528-1374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "483 W SEED FARM RD",
"city": "SACATON",
"state": "AZ",
"postal_code": "851475000",
"telephone_number": "602-528-7100",
"fax_number": "602-528-1374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "JOE",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-03-21",
"last_updated": "2025-03-21",
"certification_date": "2025-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AZ",
"license": "LMSW-22506",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacaton, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.