Active NPI
Shane Patrick Lightle
- Clinical Social Worker
- Milton, WV
National Provider Identifier
1346861697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 1249 Meadow LN
Milton, WV 25541-8577 - Phone
- (304) 840-8686
- NPI assigned
- Apr 28, 2020
- Sex
- Male
- 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 | Primary |
Addresses
Primary practice location
1249 Meadow LN
Milton, WV 25541-8577
Mailing address
1596 Washinton Blvd
Huntington, WV 25701
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588032000000",
"number": "1346861697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1596 WASHINTON BLVD",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "25701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1249 MEADOW LN",
"city": "MILTON",
"state": "WV",
"postal_code": "255418577",
"telephone_number": "304-840-8686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIGHTLE",
"first_name": "SHANE",
"middle_name": "PATRICK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-28",
"last_updated": "2020-04-28",
"certification_date": "2020-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.