Active NPI
Shannon Houselog, LCSW
- Clinical Social Worker
- Palmdale, CA
National Provider Identifier
1518135482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW65672
- Practice address
- 1020 E Palmdale Blvd
Suite 101B
Palmdale, CA 93550-4756 - Phone
- (661) 274-0770
- Fax
- (661) 274-9970
- NPI assigned
- Feb 13, 2008
- Sex
- Female
- Sole proprietor
- No
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 | LCSW65672 | CA | Primary |
Addresses
Primary practice location
1020 E Palmdale Blvd
Suite 101B
Palmdale, CA 93550-4756
Mailing address
1020 E Palmdale Blvd
Suite 101B
Palmdale, CA 93550-4756
Phone (661) 274-0770
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW65672 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429833600000",
"number": "1518135482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 E PALMDALE BLVD",
"address_2": "SUITE 101B",
"city": "PALMDALE",
"state": "CA",
"postal_code": "935504756",
"telephone_number": "661-274-0770",
"fax_number": "661-274-9970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 E PALMDALE BLVD",
"address_2": "SUITE 101B",
"city": "PALMDALE",
"state": "CA",
"postal_code": "935504756",
"telephone_number": "661-274-0770",
"fax_number": "661-274-9970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOUSELOG",
"first_name": "SHANNON",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-13",
"last_updated": "2015-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCSW65672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palmdale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.