Active NPI
Shannon Kay Durham, LCSW
- Clinical Social Worker
- Warsaw, MO
National Provider Identifier
1508016932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2008009872
- Practice address
- 1620 Hilltop Dr
Warsaw, MO 65355-3057 - Phone
- (660) 428-1280
- Fax
- (660) 428-1283
- NPI assigned
- Sep 23, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2008009872 | MO | Primary |
Addresses
Primary practice location
1620 Hilltop Dr
Warsaw, MO 65355-3057
Mailing address
1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8186
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2008009872 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477612800000",
"number": "1508016932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 COMMUNITY",
"city": "CLINTON",
"state": "MO",
"postal_code": "647358804",
"telephone_number": "660-885-8186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 HILLTOP DR",
"city": "WARSAW",
"state": "MO",
"postal_code": "653553057",
"telephone_number": "660-428-1280",
"fax_number": "660-428-1283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DURHAM",
"first_name": "SHANNON",
"middle_name": "KAY",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-23",
"last_updated": "2016-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2008009872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warsaw, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.