Individual provider Active NPI

Shaylin Marie Herdman, LICSW

  • Clinical Social Worker
  • Weymouth, MA
National Provider Identifier
1407426331
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LICSW1121574 Issued in MA
Practice address
169 Libbey Pkwy
Weymouth, MA 02189-3189
Phone
(508) 238-7766
NPI assigned
Jul 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X
Clinical Social Worker 1041C0700X LICSW1121574 MA Primary

Addresses

Primary practice location

169 Libbey Pkwy
Weymouth, MA 02189-3189

Mailing address

698 South Ave
Whitman, MA 02382-2214
Phone (617) 699-5844

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL 5085862660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20260325001294 MA Practitioner - Clinical Social Worker 9032693254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4800 N Scottsdale Rd
Suite 2500
Scottsdale, AZ 85251-7630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICSW1121574MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC Clinical Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1407426331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "698 SOUTH AVE",
            "city": "WHITMAN",
            "state": "MA",
            "postal_code": "023822214",
            "telephone_number": "617-699-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 LIBBEY PKWY",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893189",
            "telephone_number": "508-238-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERDMAN",
        "first_name": "SHAYLIN",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW1121574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "5085862660",
            "affiliation": "N",
            "address_1": "231 Main St Fl 3",
            "city": "Brockton",
            "state": "MA",
            "country_code": "US",
            "postal_code": "023014342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

Verify at the official NPI Registry.