Shannon Keefer, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I 1440415 Issued in OH

Practice address

10261 Reed Rd
Monclova, OH 43542-9659

Phone

(419) 509-3204

NPI assigned

Jun 2, 2014

Last updated

Jun 2, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in OH

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

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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.

• Diana Lynn Theiss, PH.D., LISW-S

  • Clinical Social Worker
  • Sylvania, OH
  • NPI 1265722813
  Medicare reassignment
• Diana L Theiss PHD

  dba Sylvania Therapy and Counseling

  • Clinical Social Worker
  • Sylvania, OH
  • NPI 1396250338
  NPD (past)

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1346652815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10261 REED RD",
            "city": "MONCLOVA",
            "state": "OH",
            "postal_code": "435429659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10261 REED RD",
            "city": "MONCLOVA",
            "state": "OH",
            "postal_code": "435429659",
            "telephone_number": "419-509-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFER",
        "first_name": "SHANNON",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-02",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 1440415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Marie Gerken, OTR
• Lee C Grinonneau, P.T., M.S.
• Daniel Harrison
• Brandi Elizabeth Hickman, COTA/L
• Kaylee Mae Hull, MAT, AT, ATC
• Carmen Kosmider, LMT
• Michelle Marie Kummer, SLP
• Wendell Raymond Link Jr., RN
• Tiffany Renee Malone, OTA/L
• Monclova Township

• Clinical Social Worker in Monclova, OH
• Providers in Monclova, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.