Active NPI
Shannon Kristi Waliser, MSW, MPA, LICSW
- Clinical Social Worker
- Morgantown, WV
National Provider Identifier
1285878025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- DP00942521
- Practice address
- 295 High St Ste 3
Morgantown, WV 26505-5449 - Phone
- (304) 363-4265
- Fax
- (304) 999-4826
- NPI assigned
- Apr 23, 2009
- Sex
- Female
- 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 | DP00942521 | WV | Primary |
Addresses
Primary practice location
295 High St Ste 3
Morgantown, WV 26505-5449
Mailing address
PO Box 1286
Morgantown, WV 26507-1286
Phone (304) 363-4265
Other practice location 1
1042 Morgantown Ave
Suite 22
Fairmont, WV 26554-0132
Phone (304) 363-4265
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595376000000",
"number": "1285878025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1286",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265071286",
"telephone_number": "304-363-4265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 HIGH ST STE 3",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265055449",
"telephone_number": "304-363-4265",
"fax_number": "304-999-4826"
}
],
"practiceLocations": [
{
"address_1": "1042 Morgantown Ave",
"address_2": "Suite 22",
"address_purpose": "LOCATION",
"city": "Fairmont",
"state": "WV",
"postal_code": "265540132",
"country_code": "US",
"telephone_number": "304-363-4265",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALISER",
"first_name": "SHANNON",
"middle_name": "KRISTI",
"name_prefix": "Ms.",
"credential": "MSW, MPA, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-23",
"last_updated": "2020-07-22",
"certification_date": "2020-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WV",
"license": "DP00942521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.