Active NPI
Shannon E. Ferry Branaugh, LCSW
- Clinical Social Worker
- Eugene, OR
National Provider Identifier
1134590730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L10532
- Practice address
- 541 Willamette St Ste 407a
Eugene, OR 97401-2696 - Phone
- (541) 209-0289
- Fax
- (999) 999-9999
- NPI assigned
- Oct 8, 2015
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Social Worker | 104100000X | OR | ||
| Clinical Social Worker | 1041C0700X | L10532 | OR | Primary |
Addresses
Primary practice location
541 Willamette St Ste 407a
Eugene, OR 97401-2696
Mailing address
541 Willamette St Ste 407a
Eugene, OR 97401-2696
Phone (541) 209-0289
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| L10532 | Other | OR | LCSW LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.radembodycounseling.com |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651190400000",
"number": "1134590730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "541 WILLAMETTE ST STE 407A",
"city": "EUGENE",
"state": "OR",
"postal_code": "974012696",
"telephone_number": "541-209-0289",
"fax_number": "999-999-9999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "541 WILLAMETTE ST STE 407A",
"city": "EUGENE",
"state": "OR",
"postal_code": "974012696",
"telephone_number": "541-209-0289",
"fax_number": "999-999-9999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERRY BRANAUGH",
"first_name": "SHANNON",
"middle_name": "E.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-08",
"last_updated": "2022-04-29",
"certification_date": "2022-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OR",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L10532",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW LICENSE",
"identifier": "L10532",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.radembodycounseling.com",
"affiliation": "N",
"endpointDescription": "Practice Website",
"address_1": "5305 River Rd N Ste B",
"city": "Keizer",
"state": "OR",
"country_code": "US",
"postal_code": "973035324",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.