Shannon Marie Haley, MSW, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12441 Issued in MD

Practice address

40 S 2ND St
Oakland, MD 21550-1518

Phone

(301) 914-1351

Fax

(301) 334-7642

NPI assigned

Dec 3, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Garrett County Board of Education

  • Local Education Agency (LEA)
  • Oakland, MD
  • NPI 1114141785
  NPD (past)
• Garrett County Board of Education

  • Local Education Agency (LEA)
  • Oakland, MD
  • NPI 1629345327
  NPD (past)

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1477023471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 S 2ND ST",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215501518",
            "telephone_number": "301-914-1351",
            "fax_number": "301-334-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 S 2ND ST",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215501518",
            "telephone_number": "301-914-1351",
            "fax_number": "301-334-7642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-03",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "905202000",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "541388500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• GRMC, Inc.
• GRMC, Inc.
• GRMC, Inc.
• Grounded Living Therapy, LLC
• Colleen Virginia Groves, R.D., L.D., C.D.E.
• Georgia Abigail Hall, BCBA
• Hannahs Gift MD LLC
• Harford Direct Care LLC
• Angelene Harrison, M.S., ED.S.
• Carole B Hart, LCSWC

• Clinical Social Worker in Oakland, MD
• Providers in Oakland, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.