Shanelle Damaso, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW17394 Issued in FL

Practice address

2721 Del Prado Blvd S Ste 200
Cape Coral, FL 33904-5783

Phone

(239) 673-9034

Fax

(239) 673-9102

NPI assigned

Sep 10, 2015

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

• Shanelle Walters Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

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 and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1457729246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 METRO PKWY STE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169416",
            "telephone_number": "239-236-8784",
            "fax_number": "239-790-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2721 DEL PRADO BLVD S STE 200",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339045783",
            "telephone_number": "239-673-9034",
            "fax_number": "239-673-9102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2789 Ortiz Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339057806",
            "country_code": "US",
            "telephone_number": "239-275-3222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMASO",
        "first_name": "SHANELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "W436-785-93-675-0",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANELLE",
            "last_name": "WALTERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Darvis Eduardo Dager Lissabet, MD
• Diana Daigle, LMHC
• Emmanuel De Jesus Dalama Borges
• Joseph C Daley III, M.D.
• Dennis Wade Dalton, DDS
• April Daniel
• Bronna P Daniel
• Volha Daniel, APRN
• Carolyn Louise Daniels, PHD, LCSW, CT
• Amanda Lillian Danley, MD

• Clinical Social Worker in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.