Vanessa Marie Shoop, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW004933 Issued in GA

Practice address

4549 Tiffany LN
Loganville, GA 30052-3590

Phone

(678) 910-8772

NPI assigned

Dec 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410307200000",
    "number": "1740342344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4549 TIFFANY LN",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300523590",
            "telephone_number": "678-910-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4549 TIFFANY LN",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300523590",
            "telephone_number": "678-910-8772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOP",
        "first_name": "VANESSA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2014-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW004019",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Signature Plastic Surgery, LLC
• Naomi M Simpson, LCSW
• Jennifer Marie Sims, MS, OTR/L

• Clinical Social Worker in Loganville, GA
• Providers in Loganville, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; 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.