Individual provider Active NPI

M Shawn Palau, LCSW

  • Clinical Social Worker
  • Harrisville, UT
National Provider Identifier
1609946540
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
271082-3501 Issued in UT
Practice address
811 N Harrisville Rd
Harrisville, UT 84404-3537
Phone
(801) 399-1818
Fax
(801) 782-8412
NPI assigned
Nov 8, 2006
Last updated
May 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 271082-3501 UT Primary

Addresses

Primary practice location

811 N Harrisville Rd
Harrisville, UT 84404-3537

Mailing address

811 N Harrisville Rd
Harrisville, UT 84404-3537
Phone (801) 399-1818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20050429000826 UT Practitioner - Clinical Social Worker 6204875024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Hawaii John a. Burns School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aloha Behavioral Consultants, Inc.Group PAC ID 2961501804, 7 clinicians

Practice addresses (Care Compare)

811 N Harrisville Rd
Harrisville, UT 84404-3537
Phone (801) 399-1818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
271082-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aloha Behavioral Consultants, Inc. Clinical CurrentSince Mar 7, 2007 Accepting new patients
Aloha Medical Services, LLC PastSince Jun 14, 2020 Accepting new patients

Locations

811 N Harrisville Rd
Ogden, UT 84404
Phone (801) 399-1818

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

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1609946540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 N HARRISVILLE RD",
            "city": "HARRISVILLE",
            "state": "UT",
            "postal_code": "844043537",
            "telephone_number": "801-399-1818",
            "fax_number": "801-782-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 N HARRISVILLE RD",
            "city": "HARRISVILLE",
            "state": "UT",
            "postal_code": "844043537",
            "telephone_number": "801-399-1818",
            "fax_number": "801-782-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALAU",
        "first_name": "M SHAWN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "271082-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisville, UT

Sources for this page

Verify at the official NPI Registry.