Colleen R Shaughency, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10800151 Issued in OH

Practice address

1080 Lexington Ave
Mansfield, OH 44907-2250

Phone

(419) 756-9975

NPI assigned

Aug 14, 2008

Last updated

Aug 25, 2026By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Third Street Community Clinic, Inc.Group PAC ID 2365423977, shared by 13 NPIs, 29 clinicians

Practice addresses (Care Compare)

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.

• Third Street Community Clinic Inc

  dba Five Points Primary Care

  • Federally Qualified Health Center (FQHC)
  • Mansfield, OH
  • NPI 1972053452
  Medicare reassignment NPD
• Third Street Community Clinic, Inc

  dba Cline Avenue Health and Wellness

  • Federally Qualified Health Center (FQHC)
  • Mansfield, OH
  • NPI 1720407554
  Medicare reassignment NPD
• Third Street Community Clinic, Inc.

  dba Cornerstone OB/GYN

  • Federally Qualified Health Center (FQHC)
  • Mansfield, OH
  • NPI 1649599119
  Medicare reassignment NPD
• Third Street Community Clinic, Inc.

  dba Malabar Care Connect

  • Federally Qualified Health Center (FQHC)
  • Mansfield, OH
  • NPI 1306499314
  Medicare reassignment
• Life Steps Inc

  • Clinical Social Worker
  • Mansfield, OH
  • NPI 1588870646
  NPD
• Third Street Community Clinic, Inc.

  dba Hawkins Medical Center

  • Federally Qualified Health Center (FQHC)
  • Ontario, OH
  • NPI 1427492271
  NPD

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1619123288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449072250",
            "telephone_number": "419-756-9975",
            "fax_number": "419-756-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449072250",
            "telephone_number": "419-756-9975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAUGHENCY",
        "first_name": "COLLEEN",
        "middle_name": "R",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-14",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "10800151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anatoliy Joseph Shakh, M.D.
• Wasif Elahi Shamsi, MD
• Kayla S Shank
• Megan G Sharp
• Shavontia Sharrock
• Jeffrey Shaull
• Rhema Rachelle Shaull
• Ricki Lynn Shaull
• Tammy Shaull
• Alona Shaver

• Clinical Social Worker in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.