Terry Lynn Shirley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2013033736 Issued in MO

Practice address

1112 Linden St
Cape Girardeau, MO 63703-7707

Phone

(573) 334-5513

Fax

(573) 334-0312

NPI assigned

May 11, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, MI2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ausable Valley Community Mental Health Services BoardGroup PAC ID 2961485610, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ausable Valley Community Mental Health Services Board

  • Community/Behavioral Health Agency
  • Tawas City, MI
  • NPI 1417011701
  Medicare reassignment Care Compare group NPD
• Blue Ridge Community Health Services Inc.

  dba Blue Ridge Health-Givens Gerber

  • Federally Qualified Health Center (FQHC)
  • Asheville, NC
  • NPI 1679137558
  Medicare reassignment NPD
• Blue Ridge Community Health Services, Inc

  dba Haywood Health Center

  • Federally Qualified Health Center (FQHC)
  • Clyde, NC
  • NPI 1407200264
  Medicare reassignment NPD
• Blue Ridge Community Health Services, Inc

  dba 7th Avenue Health Center

  • Federally Qualified Health Center (FQHC)
  • Hendersonville, NC
  • NPI 1801261391
  Medicare reassignment NPD
• Blue Ridge Community Health Services, Inc

  dba Sylva Health Center

  • Federally Qualified Health Center (FQHC)
  • Sylva, NC
  • NPI 1881130540
  Medicare reassignment NPD
• Blue Ridge Community Health Services, Inc.

  dba Blue Ridge Health-Swain

  • Federally Qualified Health Center (FQHC)
  • Bryson City, NC
  • NPI 1124668868
  Medicare reassignment NPD
• Blue Ridge Community Health Services, Inc.

  dba Polk Health Center

  • Federally Qualified Health Center (FQHC)
  • Columbus, NC
  • NPI 1750757803
  Medicare reassignment NPD

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1407148364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 LINDEN ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637037707",
            "telephone_number": "573-334-5513",
            "fax_number": "573-334-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 LINDEN ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637037707",
            "telephone_number": "573-334-5513",
            "fax_number": "573-334-0312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 Griffin Rd",
            "address_purpose": "LOCATION",
            "city": "West Branch",
            "state": "MI",
            "postal_code": "486619251",
            "country_code": "US",
            "telephone_number": "989-362-8636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "TERRY",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-11",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2013033736",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801115644",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1407148364",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William H Shipley Jr., DDS
• Michael Shipman
• Stacia Renee Shipman, PT
• Christina Louise Shirk, FNP-BC
• McKenzie Shirley
• Heather R Shirrell, PLPC
• Jessica Shirrell
• Nathan Michael Shortt
• Show Me State Infusion Clinic, LLC (Show Me State Vital Care)
• Brittany L Showmaker

• Clinical Social Worker in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.