Active NPI
Kathleen Connie Shaw, LLMSW
- Clinical Social Worker
- Harrison TWP, MI
National Provider Identifier
1134477573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3079975
- Practice address
- 34367 Virgil St
Harrison TWP, MI 48045-3387 - Phone
- (586) 822-1298
- NPI assigned
- Aug 15, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 3079975 | MI | Primary |
Addresses
Primary practice location
34367 Virgil St
Harrison TWP, MI 48045-3387
Mailing address
34367 Virgil St
Harrison TWP, MI 48045-3387
Phone (586) 822-1298
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3079975 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344988800000",
"number": "1134477573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34367 VIRGIL ST",
"city": "HARRISON TWP",
"state": "MI",
"postal_code": "480453387",
"telephone_number": "586-822-1298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34367 VIRGIL ST",
"city": "HARRISON TWP",
"state": "MI",
"postal_code": "480453387",
"telephone_number": "586-822-1298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAW",
"first_name": "KATHLEEN",
"middle_name": "CONNIE",
"name_prefix": "Ms.",
"credential": "LLMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-15",
"last_updated": "2012-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "3079975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harrison TWP, MI
- Melissa Rutherford
- Joanna Catherine Scheunemann, FNP-BC
- Michelle Sophia Schmatz, DPT
- Pamela Jean Semaan
- Serenity Now
- Karen Sogge, RN
- Spi Senior Living
- St John Harrison Township Urgent Care
- St. John Hospital and Medical Center (St John North Shores Hospital)
- St. John North Shores Emergency Physicians, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.