Active NPI
Shanna Ryan Rios, LCSWA, LCASA
- Clinical Social Worker
- Jacksonville, NC
National Provider Identifier
1669147609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P016645
- Practice address
- 119 Foggy River Way
Jacksonville, NC 28540-8074 - Phone
- (910) 545-1799
- NPI assigned
- Aug 11, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCAS-27490 | NC | |
| Clinical Social Worker | 1041C0700X | P016645 | NC | Primary |
Addresses
Primary practice location
119 Foggy River Way
Jacksonville, NC 28540-8074
Mailing address
119 Foggy River Way
Jacksonville, NC 28540-8074
Phone (910) 545-1799
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCAS-27490 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| P016645 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628726400000",
"number": "1669147609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 FOGGY RIVER WAY",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285408074",
"telephone_number": "910-545-1799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 FOGGY RIVER WAY",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285408074",
"telephone_number": "910-545-1799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIOS",
"first_name": "SHANNA",
"middle_name": "RYAN",
"name_prefix": "Ms.",
"credential": "LCSWA, LCASA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-11",
"last_updated": "2021-08-12",
"certification_date": "2021-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "LCAS-27490",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P016645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.