Active NPI
Shannice T Clark, MSW, LSW
- Social Worker
- Cincinnati, OH
National Provider Identifier
1225776131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 1502424
- Practice address
- 432 Ray Norrish Dr
Cincinnati, OH 45246-1520 - Phone
- (513) 802-5080
- NPI assigned
- May 23, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 1502424 | OH | Primary |
Addresses
Primary practice location
432 Ray Norrish Dr
Cincinnati, OH 45246-1520
Mailing address
432 Ray Norrish Dr
Cincinnati, OH 45246-1520
Phone (513) 802-5080
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 |
|---|---|---|---|
| 1502424 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653264000000",
"number": "1225776131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "432 RAY NORRISH DR",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452461520",
"telephone_number": "513-802-5080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "432 RAY NORRISH DR",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452461520",
"telephone_number": "513-802-5080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "SHANNICE",
"middle_name": "T",
"credential": "MSW, LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-23",
"last_updated": "2022-05-23",
"certification_date": "2022-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "1502424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.