Shanna Marie Hoekstra, MA, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.014598 Issued in IL

Practice address

3590 Hobson Rd Ste 401
Woodridge, IL 60517-1492

Phone

(630) 968-0792

Fax

(630) 477-0201

NPI assigned

Mar 14, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Shanna Blair Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1467955625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590 HOBSON RD STE 401",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605171492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 HOBSON RD STE 401",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605171492",
            "telephone_number": "630-968-0792",
            "fax_number": "630-477-0201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E Main St",
            "address_purpose": "LOCATION",
            "city": "St Charles",
            "state": "IL",
            "postal_code": "601741948",
            "country_code": "US",
            "telephone_number": "630-587-3777 x101",
            "fax_number": "630-587-3791",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOEKSTRA",
        "first_name": "SHANNA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MA, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.014598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNA",
            "last_name": "BLAIR",
            "prefix": "MS.",
            "credential": "MA, LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Social Worker in Woodridge, IL
• Providers in Woodridge, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.