Zully Soledad Shupe, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-842 Issued in WY

Practice address

1430 Wilkins Cir
Casper, WY 82601-1336

Phone

(307) 237-9583

NPI assigned

Jul 26, 2012

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

Other names 1

• Zully Soledad Garcia-Diaz Professional name

Medicare fee-for-service enrollment

Enrolled in WY

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

Specialty

Clinical Social Worker

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Wyoming Counseling CenterGroup PAC ID 7416270939, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Central Wyoming Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Casper, WY
  • NPI 1730183617
  Medicare reassignment Care Compare group
• Natrona County Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Casper, WY
  • NPI 1578487104
  NPD (past)

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1417203589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 WILKINS CIR",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826011336",
            "telephone_number": "307-237-9583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 WILKINS CIR",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826011336",
            "telephone_number": "307-237-9583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUPE",
        "first_name": "ZULLY",
        "middle_name": "SOLEDAD",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-26",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "327074-3501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ZULLY",
            "last_name": "GARCIA-DIAZ",
            "middle_name": "SOLEDAD",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Francis M Short
• Carla J Shriver, MS CCC/SLP
• William R Shughart, PA-C
• Kathleen Amy Shumway, CSW
• Philip Shupe, LCSW
• Gregory Allen Shuttleworth, FNP
• Dede L Sievers
• Karlynn D. Sievers, MD
• Signature Dental LLC
• Eric H Siiteri, PH.D

• Clinical Social Worker in Casper, WY
• Providers in Casper, WY by specialty
• Clinical Social Worker in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; 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.