Individual provider Active NPI

Shannon R Lavoie-Thompson, LMSW

  • Social Worker
  • Caro, MI
National Provider Identifier
1174634703
Registry record updated May 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6802081338 Issued in MI
Practice address
1332 Prospect Ave
Caro, MI 48723-9288
Phone
(989) 673-6191
Fax
(989) 672-3443
NPI assigned
Aug 31, 2006
Last updated
May 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2016

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 6802081338 MI Primary

Addresses

Primary practice location

1332 Prospect Ave
Caro, MI 48723-9288

Mailing address

323 N State St
PO Box 239
Caro, MI 48723-1537
Phone (989) 673-6191

Other names 1

  • Shannon R Eveleigh Former name

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

LicenseStateTypeSpecialty
6802081338MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1174634703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 N STATE ST",
            "address_2": "PO BOX 239",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487231537",
            "telephone_number": "989-673-6191",
            "fax_number": "989-673-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 PROSPECT AVE",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487239288",
            "telephone_number": "989-673-6191",
            "fax_number": "989-672-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVOIE-THOMPSON",
        "first_name": "SHANNON",
        "middle_name": "R",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802081338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "EVELEIGH",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Caro, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.