Phyllis Ann Shanklin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

123 Professional Park Dr Ste 101
Mooresville, NC 28117

Phone

(704) 399-7976

NPI assigned

May 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1557446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1386200848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 PROFESSIONAL PARK DR",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 PROFESSIONAL PARK DR STE 101",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-399-7976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3549 N Sharon Amity Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282052975",
            "country_code": "US",
            "telephone_number": "704-469-1243",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3549 N Sharon Amity Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282052975",
            "country_code": "US",
            "telephone_number": "704-469-1243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHANKLIN",
        "first_name": "PHYLLIS",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-10",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Murdoch Self
• Amanda Elizabeth Sellers, PMHNP-BC
• Grace Marie Selvaggi, CSW, CMSW, LCSWA
• David Martin Senigla
• Kellie Sexton
• Shannon G. Parsons of North Carolina P.a
• Gillian Sharp, OTR/L
• Heather Anne Shaw, MS, CCC-SLP
• Daniel Shears, RPH
• Lauren Ellard Shelton, PHARMD

• Clinical Social Worker in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; 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.