Shanique Elizabeth Walker, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

121088 Issued in CA

Practice address

1080 Marina Village Pkwy Ste 100
Alameda, CA 94501-1078

Phone

(510) 769-4106

NPI assigned

Nov 29, 2021

Last updated

Jun 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD
• Destiny Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • San Ramon, CA
  • NPI 1124893482
  NPD
• Destiny Healthcare, LLC

  • Community/Behavioral Health Agency
  • San Ramon, CA
  • NPI 1922701390
  NPD

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1700544566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 MARINA VILLAGE PKWY STE 100",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011078",
            "telephone_number": "510-769-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 MARINA VILLAGE PKWY STE 100",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011078",
            "telephone_number": "510-769-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "SHANIQUE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "121088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #09248)
• Walgreen Co (Walgreens #04050)
• Beth Marie Walker Gram, LAC
• Elaina Walker
• Georganne Walker, P.N.P.
• Lashonda M Wallace
• Tim Wallace
• Jamie Elise Wallach, MD
• Emily Louise-Paula Walters, MSW CANDIDATE
• Carlton Louis Walton

• Clinical Social Worker in Alameda, CA
• Providers in Alameda, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.

Verify at the official NPI Registry.