Individual provider Active NPI

Shanese N Williams, LCSW, LICSW

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1568179398
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC20000206 Issued in DC
Practice address
2918 Minnesota Ave SE
Washington, DC 20019-1127
Phone
(202) 839-5310
NPI assigned
Nov 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LC20000206 DC
Clinical Social Worker 1041C0700X 0904014497 VA
Clinical Social Worker 1041C0700X LC20000206 DC Primary

Addresses

Primary practice location

2918 Minnesota Ave SE
Washington, DC 20019-1127

Mailing address

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031-4512
Phone (571) 495-9386

Other practice location 1

217 51st St NE Apt 21
Washington, DC 20019-5421
Phone (202) 702-2180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20230113001882 DC Practitioner - Clinical Social Worker 4284005026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8221 Willow Oaks Corporate Dr
Fairfax Falls Church Community Services Boa
Fairfax, VA 22031-4512
Phone (703) 321-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC20000206DCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aneu Lyfe Clinical Current Accepting new patients
Fairfax County, Virginia CurrentSince Oct 26, 2022 Accepting new patients

Locations

12011 Government Center Pkwy
Ste 836
Fairfax, VA 22035
Phone (703) 324-7017

8221 Willow Oaks Corporate Dr
Fairfax, VA 22031
Phone (703) 289-7599

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1568179398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8221 WILLOW OAKS CORPORATE DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314512",
            "telephone_number": "571-495-9386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2918 MINNESOTA AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200191127",
            "telephone_number": "202-839-5310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 51st St NE Apt 21",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200195421",
            "country_code": "US",
            "telephone_number": "202-702-2180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "SHANESE",
        "middle_name": "N",
        "credential": "LCSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-01",
        "last_updated": "2025-07-14",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "DC",
            "license": "LC20000206",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904014497",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC20000206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.