Individual provider Active NPI

Shatina Marks, LMSW

  • Social Worker
  • Flint, MI
National Provider Identifier
1124368634
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6802086902 Issued in MI
Practice address
4318 Miller Rd
Flint, MI 48507-1267
Phone
(810) 249-9924
Fax
(810) 249-9927
NPI assigned
Feb 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Social Worker 104100000X 6802086902 MI Primary

Addresses

Primary practice location

4318 Miller Rd
Flint, MI 48507-1267

Mailing address

1013 N River Rd
Saginaw, MI 48609-6833
Phone (989) 859-6135

Other practice location 1

2702 Flushing Rd
Flint, MI 48504-4534
Phone (810) 471-9888

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6802086902MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Rehabilitation Center, Inc. Current Accepting new patients
Best Me Counseling Services LLC Social Worker CurrentSince Aug 5, 2020 Accepting new patients
Holy Cross Youth and Family Services Inc PastSince Mar 4, 2017 Accepting new patients

Locations

2091 Professional Dr
Flint, MI 48532
Phone (810) 732-1652

742 Neubert Ave
Flint, MI 48507
Phone (248) 920-9909

400 Stoddard Rd
Richmond, MI 48062

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1124368634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 N RIVER RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486096833",
            "telephone_number": "989-859-6135",
            "fax_number": "989-401-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4318 MILLER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071267",
            "telephone_number": "810-249-9924",
            "fax_number": "810-249-9927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2702 Flushing Rd",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485044534",
            "country_code": "US",
            "telephone_number": "810-471-9888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARKS",
        "first_name": "SHATINA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-20",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802086902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.