Shane Speaker, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801094324 Issued in MI

Practice address

200 Vista Dr
Coldwater, MI 49036-1776

Phone

(517) 278-2129

NPI assigned

Jan 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Branch County Community Mental Health AuthorityGroup PAC ID 4789612714, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Branch County Community Mental Health Authority

  • Mental Health Counselor
  • Coldwater, MI
  • NPI 1861430381
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1164995684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 VISTA DR",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490361776",
            "telephone_number": "517-278-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VISTA DR",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490361776",
            "telephone_number": "517-278-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEAKER",
        "first_name": "SHANE",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louise Marie Snyder, PHD CCC SLP
• Brandon Michael Soldano, D.C.
• Danielle May Sommers, BA, QMHP, QIDP, CMHP
• Karen Spangler, PT
• Tammy Spaulding
• Speech & Language Services, P.C.
• Speech and Language Services, P.C.
• Raymond Spencer, BS, LBSW
• Spine & Wellness Institute, PLLC
• Lee Ann Spolyar

• Clinical Social Worker in Coldwater, MI
• Providers in Coldwater, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.