Individual provider Active NPI

Siouneh Shabandari, MSW

  • Clinical Social Worker
  • Glendale, CA
National Provider Identifier
1750792123
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW90749 Issued in CA
Practice address
237 N Central Ave
Glendale, CA 91203-3526
Phone
(818) 547-9544
Fax
(818) 547-9041
NPI assigned
May 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW67654 CA
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X LCSW90749 CA Primary

Addresses

Primary practice location

237 N Central Ave
Glendale, CA 91203-3526

Mailing address

237 N Central Ave
Glendale, CA 91203-3526
Phone (818) 547-9544

Other practice location 1

155 N Occidental Blvd
Los Angeles, CA 90026-4641
Phone (213) 381-2931

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
ASW67654CAMDMental Health Counselor
LCSW90749CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1750792123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 N CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033526",
            "telephone_number": "818-547-9544",
            "fax_number": "818-547-9041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 N CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033526",
            "telephone_number": "818-547-9544",
            "fax_number": "818-547-9041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 N Occidental Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900264641",
            "country_code": "US",
            "telephone_number": "213-381-2931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHABANDARI",
        "first_name": "SIOUNEH",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-19",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW67654",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW90749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.