Individual provider Active NPI

Shelby Leigh Havens, LLMSW

  • Clinical Social Worker
  • Saginaw, MI
National Provider Identifier
1720605694
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851107443 Issued in MI
Practice address
500 Hancock St
Saginaw, MI 48602-4224
Phone
(989) 797-3400
NPI assigned
Jun 26, 2020
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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 6851107443 MI Primary

Addresses

Primary practice location

500 Hancock St
Saginaw, MI 48602-4224

Mailing address

500 Hancock St
Saginaw, MI 48602-4224
Phone (989) 797-3400

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

State licenses

LicenseStateTypeSpecialty
6851107443MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oakland Integrated Healthcare Network PastSince Aug 23, 2023 Accepting new patients

Organizations & group practices 1

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": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1720605694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HANCOCK ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024224",
            "telephone_number": "989-797-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HANCOCK ST",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024224",
            "telephone_number": "989-797-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVENS",
        "first_name": "SHELBY",
        "middle_name": "LEIGH",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851107443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.