Active NPI
Kiki Shawn Wato, LCSW
- Clinical Social Worker
- Shiprock, NM
National Provider Identifier
1689127565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C-10805
- Practice address
- US Hwy 491 North
Shiprock, NM 87420 - Phone
- (505) 368-6001
- Fax
- (505) 368-7319
- NPI assigned
- Jul 27, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C-10805 | NM | Primary |
Addresses
Primary practice location
US Hwy 491 North
Shiprock, NM 87420
Mailing address
PO Box 160
Shiprock, NM 87420-0160
Phone (505) 368-6001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621296000000",
"number": "1689127565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 160",
"city": "SHIPROCK",
"state": "NM",
"postal_code": "874200160",
"telephone_number": "505-368-6001",
"fax_number": "505-368-7319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "US HWY 491 NORTH",
"city": "SHIPROCK",
"state": "NM",
"postal_code": "87420",
"telephone_number": "505-368-6001",
"fax_number": "505-368-7319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATO",
"first_name": "KIKI",
"middle_name": "SHAWN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-27",
"last_updated": "2021-05-18",
"certification_date": "2021-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "C-10805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shiprock, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.