NPIMap

Organization Active NPI

Shona Wellness Group LLC

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1366806184
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC50080073 Issued in DC
Legal business name
SHONA WELLNESS GROUP LLC
Practice address
1030 Kearny St NE
Washington, DC 20017-3518
Phone
(202) 431-1682
NPI assigned
Apr 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Authorized official

Name
Lisa C Campbell, LICSW
Title
Social Worker
Phone
(202) 431-1682

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 200-1064 DC
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X PRC293 DC
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X LC50080073 DC Primary

Addresses

Primary practice location

1030 Kearny St NE
Washington, DC 20017-3518

Mailing address

6621 Highgate Dr
Fort Washington, MD 20744-1002
Phone (202) 431-1682

Other identifiers 2

IdentifierTypeStateIssuer
1326468950MedicaidDC
1326475492MedicaidDC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1366806184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 HIGHGATE DR",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207441002",
            "telephone_number": "202-431-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 KEARNY ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200173518",
            "telephone_number": "202-431-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHONA WELLNESS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-07",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "202-431-1682",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "DC",
            "license": "200-1064",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "DC",
            "license": "PRC293",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50080073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326468950",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326475492",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.