Deanna Shafer, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

095192 Issued in IA

Practice address

3606 Kimball Ave
Waterloo, IA 50702-5731

Phone

(319) 408-8530

Fax

(319) 205-4515

NPI assigned

Jun 6, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Deanna Shafer LLC

  • Clinical Social Worker
  • Waterloo, IA
  • NPI 1366300758
  NPD Authorized official
• Black Hawk-Grundy Mental Health Center Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waterloo, IA
  • NPI 1316944598
  NPD (past)

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1649839481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3606 KIMBALL AVE STE 6",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025731",
            "telephone_number": "319-408-8530",
            "fax_number": "319-205-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3606 KIMBALL AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025731",
            "telephone_number": "319-408-8530",
            "fax_number": "319-205-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "DEANNA",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "095192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "deanna@wildflowerandsagetherapy.com",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3606 Kimball Ave",
            "city": "Waterloo",
            "state": "IA",
            "country_code": "US",
            "postal_code": "507025731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Sell, RPH
• Prodosh R. Sen-Gupta, M.D.
• Serene Living Homes, LLC
• Rafael Serrano Riera, M.D.
• Sarah Jessica Seuntjens, CNM
• Sangeeta Shah, MD
• Ammara Shamshad, M.D.
• Danielle Sharar, CADC
• Nura Sharma
• Prakash Punj Sharma, M.D.

• Clinical Social Worker in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.