Individual provider Active NPI

Shannon Maureen Fluder, MA, LMSW

  • Social Worker
  • Homer Glen, IL
National Provider Identifier
1417835299
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW142396 Issued in PA
Practice address
13710 S Hampton CT
Homer Glen, IL 60491-9493
Phone
(505) 263-5971
NPI assigned
Aug 21, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW142396 PA Primary

Addresses

Primary practice location

13710 S Hampton CT
Homer Glen, IL 60491-9493

Mailing address

13710 S Hampton CT
Homer Glen, IL 60491-9493
Phone (505) 263-5971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SW142396PAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1417835299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13710 S HAMPTON CT",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604919493",
            "telephone_number": "505-263-5971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13710 S HAMPTON CT",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604919493",
            "telephone_number": "505-263-5971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLUDER",
        "first_name": "SHANNON",
        "middle_name": "MAUREEN",
        "credential": "MA, LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW142396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer Glen, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.