Individual provider Active NPI

Shawna Willett, LCSW

  • Clinical Social Worker
  • Eureka, CA
National Provider Identifier
1407984503
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
111271 Issued in CA
Practice address
2440 6TH St
Eureka, CA 95501-0788
Phone
(707) 382-6822
NPI assigned
Mar 1, 2007
Last updated
Nov 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 111271 CA Primary

Addresses

Primary practice location

2440 6TH St
Eureka, CA 95501-0788

Mailing address

PO Box 674
Trinidad, CA 95570-0674
Phone (707) 298-9800

Other names 1

  • Shawna Willett Other name

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
I20251110003528 CA Practitioner - Clinical Social Worker 5092205740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of HumboldtGroup PAC ID 4082516950, 21 clinicians

Practice addresses (Care Compare)

720 Wood St
Eureka, CA 95501-4413
Phone (707) 441-5466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111271CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Humboldt CurrentSince Aug 16, 2025 Accepting new patients
Humboldt County Behavioral Health CurrentSince Nov 20, 2022 Accepting new patients
County of Humboldt CurrentSince Aug 16, 2025 Accepting new patients
County of Humboldt Current Accepting new patients

Locations

2440 6th St
Eureka, CA 95501
Phone (707) 268-2800

720 Wood St
Eureka, CA 95501
Phone (707) 268-2900

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1407984503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674",
            "city": "TRINIDAD",
            "state": "CA",
            "postal_code": "955700674",
            "telephone_number": "707-298-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 6TH ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955010788",
            "telephone_number": "707-382-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLETT",
        "first_name": "SHAWNA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "111271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWNA",
            "last_name": "WILLETT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.