Shawna Park Lisw-S, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1101599 Issued in OH

Legal business name

SHAWNA PARK LISW-S, LLC

Practice address

287 W Johnstown Rd
Columbus, OH 43230-2732

Phone

(216) 299-1517

NPI assigned

Jan 16, 2015

Last updated

Jan 16, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shawna Park, LISW-SNPI 1679822084

Title

Owner

Phone

(216) 299-1517

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shawna B Park, LISW-S, LCDC III

  • Clinical Social Worker
  • Columbus, OH
  • NPI 1679822084
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1421366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421366400000",
    "number": "1699164434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2327 GAVINLEY WAY",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432207335",
            "telephone_number": "216-299-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "287 W JOHNSTOWN RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432302732",
            "telephone_number": "216-299-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWNA PARK LISW-S, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-16",
        "last_updated": "2015-01-16",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "216-299-1517",
        "authorized_official_credential": "LISW-S"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "1101599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shatonya Shaw, PHD
• Stephen Thomas Shaw, MD
• Wendy Shaw
• Suhair Shawar
• Lalanna Renee Shawgo, AGACNP
• Shawntis Homecare LLC
• Angela Shawver, RD, LD, CDCES
• Jonathan Shay
• Kayla Marie Shay, LSW
• Kimberly R Shay

• Clinical Social Worker in Columbus, OH
• Providers in Columbus, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.