Active NPI
Shawn A Lee
- Clinical Social Worker
- Marion, IN
National Provider Identifier
1194122317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34006428A
- Practice address
- 101 S Washington St
Suite 200
Marion, IN 46952-3867 - Phone
- (765) 662-9971
- NPI assigned
- Dec 3, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34006428A | IN | Primary |
Addresses
Primary practice location
101 S Washington St
Suite 200
Marion, IN 46952-3867
Mailing address
17889 N Wheeling Ave
Gaston, IN 47342-8923
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100124250 | Medicaid | IN |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34006428A | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Service Society Inc | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Marion, IN
- NPI 1780734806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417564800000",
"number": "1194122317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17889 N WHEELING AVE",
"city": "GASTON",
"state": "IN",
"postal_code": "473428923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 S WASHINGTON ST",
"address_2": "SUITE 200",
"city": "MARION",
"state": "IN",
"postal_code": "469523867",
"telephone_number": "765-662-9971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SHAWN",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-03",
"last_updated": "2014-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34006428A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100124250",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marion, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.