Shannon Hurlbut, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11131-123 Issued in WI

Practice address

320 S. Walnut St.
Appleton, WI 54911-5918

Phone

(920) 832-5270

Fax

(920) 832-4767

NPI assigned

Jul 30, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1124672969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 S. WALNUT ST.",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115918",
            "telephone_number": "920-832-5270",
            "fax_number": "920-832-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S. WALNUT ST.",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115918",
            "telephone_number": "920-832-5270",
            "fax_number": "920-832-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLBUT",
        "first_name": "SHANNON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-30",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "127443",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11131-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100160659",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Humiston, APSW
• Rajbir Hundal, MD
• Jennifer A Hunt, MD
• Gregory J Hunter, MD
• Richard Huntley, C.R.N.A.
• Madalyn M Hurley, DPT
• Kara Hurst, MSW, APSW
• Jeremy Hafiz Husain I, PHARMD
• Indira Husic, DNP FNP APNP
• Kathleen N Huskey

• Clinical Social Worker in Appleton, WI
• Providers in Appleton, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.