Individual provider Active NPI

Shalynn Micole McFadden

  • Clinical Social Worker
  • Conroe, TX
National Provider Identifier
1326639774
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
62281 Issued in TX
Practice address
233 SGT Ed Holcomb Blvd S
Conroe, TX 77304-1990
Phone
(936) 521-6100
NPI assigned
Jan 28, 2021
Last updated
Jan 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 62281 TX Primary

Addresses

Primary practice location

233 SGT Ed Holcomb Blvd S
Conroe, TX 77304-1990

Mailing address

233 SGT Ed Holcomb Blvd S
Conroe, TX 77304-1990
Phone (936) 521-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20210209001105 TX Practitioner - Clinical Social Worker 7113332958 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62281TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-County Behavioral Healthcare CurrentSince Jan 20, 2021 Accepting new patients

Locations

233 Sgt Ed Holcomb Blvd S
Conroe, TX 77304
Phone (936) 521-6151

706 Old Montgomery Rd
Conroe, TX 77301
Phone (936) 538-1102

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1326639774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 SGT ED HOLCOMB BLVD S",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773041990",
            "telephone_number": "936-521-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 SGT ED HOLCOMB BLVD S",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773041990",
            "telephone_number": "936-521-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCFADDEN",
        "first_name": "SHALYNN",
        "middle_name": "MICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "62281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.