Individual provider Active NPI

Brianna Shacole Marshall, LCSW

  • Clinical Social Worker
  • Fresno, CA
National Provider Identifier
1770140626
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
98579 Issued in CA
Practice address
4235 W Capitola Ave
Fresno, CA 93722-6010
Phone
(559) 274-3801
NPI assigned
May 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9099-C NV
Social Worker 104100000X CA
Clinical Social Worker 1041C0700X 98579 CA Primary

Addresses

Primary practice location

4235 W Capitola Ave
Fresno, CA 93722-6010

Mailing address

PO Box 6237
Goodyear, AZ 85338-0621
Phone (559) 274-3801

Other practice location 1

9300 Valley Childrens Pl
Madera, CA 93636-8761
Phone (559) 353-5270

Other practice location 2

8708 Tomnitz Ave Unit 101
Las Vegas, NV 89178-6715
Phone (559) 274-3801

Other practice location 3

144 S L St
Dinuba, CA 93618-2323
Phone (559) 591-6680

Other practice location 4

1707 N Silverado
Mesa, AZ 85205-3790
Phone (559) 274-3801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211209001157 CA Practitioner - Clinical Social Worker 9133520497 Reassigns benefits to 1 organization
I20220201000337 AZ Practitioner - Clinical Social Worker 9133520497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4235 W Capitola Ave
Fresno, CA 93722-6010
Phone (559) 274-3801

8607 N 59TH Ave
Suite C1
Glendale, AZ 85302-5435
Phone (480) 404-0844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
98579CAMDClinical Social Worker
9099-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy With Purpose, LLC Social Worker CurrentSince Jul 20, 2021 Accepting new patients
Supportive Counseling, LLC Clinical CurrentSince Apr 6, 2021 Accepting new patients
Therapy With Purpose, LLC Clinical CurrentSince Sep 5, 2023 Accepting new patients

Locations

8607 N 59th Ave
Ste C1
Glendale, AZ 85302
Phone (480) 404-0844

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1770140626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6237",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853380621",
            "telephone_number": "559-274-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 W CAPITOLA AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937226010",
            "telephone_number": "559-274-3801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9300 Valley Childrens Pl",
            "address_purpose": "LOCATION",
            "city": "Madera",
            "state": "CA",
            "postal_code": "936368761",
            "country_code": "US",
            "telephone_number": "559-353-5270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8708 Tomnitz Ave Unit 101",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891786715",
            "country_code": "US",
            "telephone_number": "559-274-3801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "144 S L St",
            "address_purpose": "LOCATION",
            "city": "Dinuba",
            "state": "CA",
            "postal_code": "936182323",
            "country_code": "US",
            "telephone_number": "559-591-6680",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1707 N Silverado",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852053790",
            "country_code": "US",
            "telephone_number": "559-274-3801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "BRIANNA",
        "middle_name": "SHACOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-28",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "9099-C",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "98579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.