Shannon Bienkowski

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C010742 Issued in NC

Practice address

5700 Executive Center Dr Ste 110
Charlotte, NC 28212-8833

Phone

(704) 525-3255

NPI assigned

Jan 24, 2017

Sex

Female

Sole proprietor

Yes

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": "1485216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1770020109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 PEE DEE AVE",
            "address_2": "SUITE 101",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "28001",
            "telephone_number": "704-986-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 EXECUTIVE CENTER DR STE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128833",
            "telephone_number": "704-525-3255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 S Main St",
            "address_purpose": "LOCATION",
            "city": "West Hartford",
            "state": "CT",
            "postal_code": "061072441",
            "country_code": "US",
            "telephone_number": "860-869-0599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIENKOWSKI",
        "first_name": "SHANNON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "009435",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C010742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Robert Bidwell, MD, MPH
• Britney Biegel
• Jule Biel
• Gregory Bielec, M.D.
• Ashley Bienaimee
• Doris Bienz, LPC
• Lindsay Alison Bierwert, L. AC.
• Cora Biese, DPT
• Simone Biggers
• Beau Biggs

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.