Individual provider Active NPI

Shirley Mae Hansen, LCSW

  • Clinical Social Worker
  • Ventura, CA
National Provider Identifier
1356496657
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS3741 Issued in CA
Practice address
4482 Market St
Suite 405
Ventura, CA 93003-8022
Phone
(805) 339-0930
Fax
(805) 339-0930
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCS3741 CA Primary

Addresses

Primary practice location

4482 Market St
Suite 405
Ventura, CA 93003-8022

Mailing address

4482 Market St
Suite 405
Ventura, CA 93003-8022
Phone (805) 339-0930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080219000555 CA Practitioner - Clinical Social Worker 8921182619 Practice locations: Ventura, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4482 Market St
Suite 405
Ventura, CA 93003-7753
Phone (805) 339-0930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS3741CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356496657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4482 MARKET ST",
            "address_2": "SUITE 405",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930038022",
            "telephone_number": "805-339-0930",
            "fax_number": "805-339-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4482 MARKET ST",
            "address_2": "SUITE 405",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930038022",
            "telephone_number": "805-339-0930",
            "fax_number": "805-339-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "SHIRLEY",
        "middle_name": "MAE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS3741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.