Shane Michael Hamp, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

27378 Issued in MN

Practice address

1000 Radio Dr Ste 210
Woodbury, MN 55125-8444

Phone

(651) 365-8298

NPI assigned

Sep 28, 2020

Last updated

Sep 28, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Growing Together Counseling & Healing LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • River Falls, WI
  • NPI 1154046308
  NPD (past)

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1326655093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 NORFOLK AVE APT 16",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551163056",
            "telephone_number": "651-365-8298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 RADIO DR STE 210",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551258444",
            "telephone_number": "651-365-8298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMP",
        "first_name": "SHANE",
        "middle_name": "MICHAEL",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "27378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel K Halliday, L.M.F.T
• Kevin A Hallman, M.D.
• Margaret Rose Halvorsen, WHNP
• Molly Hamilton, DPT
• Kourtney Hammer-Tente
• Saeda Ariel Hampton
• Nyamudou Francess Hamza
• Hanan Health LLC
• May Yang Hang, MSN FNP
• Abigail Margo Hansen, DC

• Clinical Social Worker in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.