Wednesday Shields, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

60894840 Issued in WA

Practice address

17352 N Meadowview LN
Nine Mile Falls, WA 99026-9329

Phone

(509) 879-3595

NPI assigned

Jul 31, 2021

Last updated

Jul 31, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1627689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627689600000",
    "number": "1477226744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17352 N MEADOWVIEW LN",
            "city": "NINE MILE FALLS",
            "state": "WA",
            "postal_code": "990269329",
            "telephone_number": "509-879-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17352 N MEADOWVIEW LN",
            "city": "NINE MILE FALLS",
            "state": "WA",
            "postal_code": "990269329",
            "telephone_number": "509-879-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "WEDNESDAY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-31",
        "last_updated": "2021-07-31",
        "certification_date": "2021-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "60894840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phase 1 Physical Therapy PS
• Robby C Riddle, MD
• Israel Rodriguez
• Joel T San Nicolas, PT
• Lindsay D Sanders
• Benjamin Shuts, LICSW
• Christina M Silver, OT
• Suncrest Chiropractic PS
• Suncrest Pharmacy Group, LLC (Suncrest Pharmacy)
• Diane C Thompson, LMHC

• Clinical Social Worker in Nine Mile Falls, WA
• Providers in Nine Mile Falls, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2021; 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.