Sandra Elizabeth Shields, MSW, LICSW, BCD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00008710 Issued in WA

Practice address

175 Parfitt Way SW
Suite N250
Bainbridge Island, WA 98110-2584

Phone

(206) 780-6747

NPI assigned

Jun 19, 2007

Last updated

Dec 23, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Sandra Elizabeth Wells Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229990400000",
    "number": "1659576676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11486",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981105486",
            "telephone_number": "206-780-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 PARFITT WAY SW",
            "address_2": "SUITE N250",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981102584",
            "telephone_number": "206-780-6747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "SANDRA",
        "middle_name": "ELIZABETH",
        "credential": "MSW, LICSW, BCD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2008-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00008710",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS15413",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "WELLS",
            "middle_name": "ELIZABETH",
            "credential": "MSW, LICSW, BCD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carol B Shakow, MSW LICSW
• Cameron Shaner
• Sharron San Martino Acupuncture, LLC (Golden Owl Acupuncture)
• Daniel Caleb Sheffield, DO
• Michelle Shellenberger, M.A., LMHC
• Shift PLLC (Maia McCoy Counseling)
• Meghan Shinn, RN
• Kerri B Shoumaker, LMHCA
• Aidan Sievertson, LMT
• Chloe Samantha Simon, ATC

• Clinical Social Worker in Bainbridge Island, WA
• Providers in Bainbridge Island, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2008; 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.