Individual provider Active NPI

Shannon C Branic, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1699248690
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34006208A Issued in IN
Practice address
5511 E 82ND St Ste K
Indianapolis, IN 46250-4515
Phone
(317) 983-3781
NPI assigned
Jan 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34006208A IN Primary

Addresses

Primary practice location

5511 E 82ND St Ste K
Indianapolis, IN 46250-4515

Mailing address

7998 Windcombe Blvd
Indianapolis, IN 46240-2678
Phone (317) 450-6435

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

LicenseStateTypeSpecialty
34006208AINMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1699248690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7998 WINDCOMBE BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462402678",
            "telephone_number": "317-450-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5511 E 82ND ST STE K",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462504515",
            "telephone_number": "317-983-3781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANIC",
        "first_name": "SHANNON",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-02",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34006208A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.