Individual provider Active NPI

Shayna Agosta

  • Social Worker
  • Southfield, MI
National Provider Identifier
1144695396
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801098600 Issued in MI
Practice address
29532 Southfield Rd Ste 115
Southfield, MI 48076-2023
Phone
(248) 716-4196
NPI assigned
Dec 14, 2015
Last updated
Apr 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801098600 MI Primary

Addresses

Primary practice location

29532 Southfield Rd Ste 115
Southfield, MI 48076-2023

Mailing address

29532 Southfield Rd Ste 115
Southfield, MI 48076-2023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IL, MA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20200910000251 MI Practitioner - Clinical Social Worker 7719305671 Reassigns benefits to 1 organization
I20260416000247 IL Practitioner - Clinical Social Worker 7719305671 Reassigns benefits to 1 organization
I20260608000766 MA Practitioner - Clinical Social Worker 7719305671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Unleash Your Authenticity Counseling LLC Social Worker Current Accepting new patients
Thriving Lives Inc. PastSince Feb 1, 2020 Accepting new patients

Locations

29532 Southfield Rd
Ste 115
Southfield, MI 48076
Phone (248) 382-8984

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1144695396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29532 SOUTHFIELD RD STE 115",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29532 SOUTHFIELD RD STE 115",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762023",
            "telephone_number": "248-716-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOSTA",
        "first_name": "SHAYNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-14",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801098600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.