Individual provider Active NPI

Shaquanus Williams, LCSW

  • Clinical Social Worker
  • Gainesville, GA
National Provider Identifier
1164024907
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW009219 Issued in GA
Practice address
2524 Parkside Way
Gainesville, GA 30507-1120
Phone
(770) 317-6392
NPI assigned
Nov 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW009219 GA Primary
School Social Worker 1041S0200X CSW009219 GA

Addresses

Primary practice location

2524 Parkside Way
Gainesville, GA 30507-1120

Mailing address

2524 Parkside Way
Gainesville, GA 30507-1120
Phone (770) 317-6392

Other names 1

  • Shaquanus Dailey Woods Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260610001668 GA Practitioner - Clinical Social Worker 9234600297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
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

State licenses

LicenseStateTypeSpecialty
CSW009219GAMDClinical Social Worker

Organizations & group practices 1

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": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1164024907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2524 PARKSIDE WAY",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305071120",
            "telephone_number": "770-317-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2524 PARKSIDE WAY",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305071120",
            "telephone_number": "770-317-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHAQUANUS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-16",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW009219",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "GA",
            "license": "CSW009219",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAQUANUS",
            "last_name": "DAILEY WOODS",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.