Deonae Sheree Shackelford-McMillian, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

121067 Issued in CA

Practice address

18408 Hatteras St Unit 39
Tarzana, CA 91356-1913

Phone

(626) 200-5996

NPI assigned

May 9, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sabi Pathways Family Therapy Inc.Group PAC ID 4486166352, 5 clinicians

Practice addresses (Care Compare)

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.

• Sabi Pathways Family Therapy Inc.

  • Mental Health Counselor
  • Palm Springs, CA
  • NPI 1407444722

  Clinical

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708128000000",
    "number": "1497014666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18408 HATTERAS ST UNIT 39",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561913",
            "telephone_number": "626-200-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18408 HATTERAS ST UNIT 39",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913561913",
            "telephone_number": "626-200-5996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKELFORD-MCMILLIAN",
        "first_name": "DEONAE",
        "middle_name": "SHEREE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-09",
        "last_updated": "2024-02-17",
        "certification_date": "2024-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "121067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serene Home Health, Inc
• Yuslaine Serrano Gutierrez
• Karma Serrano
• Andrea Isabel Serrato
• Katayoun Setareh, DDS
• Amber Lynn Shaffer
• Farnam Shah Vir, L.AC
• Nirav Jayprakash Shah, MD
• Sam Shahi, DPT
• Shahin Shamsian D.D.S Inc

• Clinical Social Worker in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.