Individual provider Active NPI

Shakeyia Reauchean Spann, MBA, LCSW

  • Clinical Social Worker
  • Pembroke Pines, FL
National Provider Identifier
1720389406
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C007959 Issued in NC
Practice address
15757 Pines Blvd # 197
Pembroke Pines, FL 33027-1207
Phone
(954) 282-9443
NPI assigned
Nov 10, 2010
Last updated
Jul 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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 C007959 NC Primary

Addresses

Primary practice location

15757 Pines Blvd # 197
Pembroke Pines, FL 33027-1207

Mailing address

15757 Pines Blvd # 197
Pembroke Pines, FL 33027-1207
Phone (954) 282-9443

Other identifiers 2

IdentifierTypeStateIssuer
6009198MedicaidNC
120897900MedicaidFL

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)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
C007959NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
SRB Counseling & Consulting PLLC Clinical CurrentSince Jan 12, 2020 Accepting new patients

Locations

1100 W McNab Rd
Ste 104
Fort Lauderdale, FL 33309
Phone (954) 282-9443

2020 W McNab Rd
Ste 104
Fort Lauderdale, FL 33309

15757 Pines Blvd
Pembroke Pines, FL 33027
Phone (954) 282-9443

1945 Lakepointe Dr
Lewisville, TX 75057
Phone (214) 302-5246

Interoperability endpoints

  • Direct secure messaging: shakeyiabrown@tdh.allscriptsdirect.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1720389406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15757 PINES BLVD # 197",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271207",
            "telephone_number": "954-282-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15757 PINES BLVD # 197",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271207",
            "telephone_number": "954-282-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANN",
        "first_name": "SHAKEYIA",
        "middle_name": "REAUCHEAN",
        "name_prefix": "Ms.",
        "credential": "MBA, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-10",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6009198",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120897900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; 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.