Shaunessy Michelle Stamm, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

33005450A Issued in IN

Practice address

998 North Columbia St.
Suite 1
Union City, IN 47390

Phone

(765) 546-9173

NPI assigned

Jul 24, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248393600000",
    "number": "1689804544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N HOWARD ST",
            "city": "UNION CITY",
            "state": "IN",
            "postal_code": "473901118",
            "telephone_number": "765-964-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 NORTH COLUMBIA ST.",
            "address_2": "SUITE 1",
            "city": "UNION CITY",
            "state": "IN",
            "postal_code": "47390",
            "telephone_number": "765-546-9173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMM",
        "first_name": "SHAUNESSY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-24",
        "last_updated": "2009-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33005450A",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "0901043",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Vincent Randolph Hospital
• St. Vincent Medical Group, Inc.
• St. Vincent Physician Network, LLC
• St. Vincent Physician Network, LLC
• Christopher L Stamm, MBA,MSW,LCSW
• Jeremiah Strunc
• Dorothy S Tyo, MAT, LAT, ATC
• Walgreen Co

• Social Worker in Union City, IN
• Providers in Union City, IN by specialty
• Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; 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.