Shannon De Roque, SSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

105625 Issued in TX

Practice address

9401 Southwest Fwy
Houston, TX 77074-1407

Phone

(713) 970-7000

NPI assigned

Sep 20, 2011

Last updated

Feb 1, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Harris Center for Mental Health and Idd

  • Community/Behavioral Health Agency
  • Houston, TX
  • NPI 1346293156
  Medicare reassignment NPD

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1548543259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N 200 W",
            "address_2": "SUITE 300",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 SOUTHWEST FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741407",
            "telephone_number": "713-970-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 N 200 W",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846011677",
            "country_code": "US",
            "telephone_number": "801-373-4760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE ROQUE",
        "first_name": "SHANNON",
        "name_prefix": "Mrs.",
        "credential": "SSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "UT",
            "license": "7353963-3503U",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "105625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcos De Oliveira, LMT
• Valine Clark De Oliveira, PHARMD
• Ana Maria R De Paiva, LCSW ACP BCD
• Heloisa De Paula Silva
• Joao Luciano De Quevedo, M.D., PH.D.
• Johnson M De San Andres, CRNA
• Jamie Mackenzie De Silva, FNP-C
• De Valle & Associates Physicians PLLC
• Christopher De Valle, CSA
• Oscar Louis De Valle, M.D.

• Clinical Social Worker in Houston, TX
• Providers in Houston, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.