Individual provider Active NPI

Patricia Beth Shijka, LLMSW

  • Clinical Social Worker
  • Midland, MI
National Provider Identifier
1700222858
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801092691 Issued in MI
Practice address
218 Fast Ice Drive
Midland, MI 48642
Phone
(989) 631-2320
NPI assigned
May 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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 6801092691 MI Primary

Addresses

Primary practice location

218 Fast Ice Drive
Midland, MI 48642

Mailing address

2949 Stambough Road
Ubly, MI 48475
Phone (989) 798-4729

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
6801092691MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1700222858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2949 STAMBOUGH ROAD",
            "city": "UBLY",
            "state": "MI",
            "postal_code": "48475",
            "telephone_number": "989-798-4729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 FAST ICE DRIVE",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "48642",
            "telephone_number": "989-631-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIJKA",
        "first_name": "PATRICIA",
        "middle_name": "BETH",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-16",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.