Omotayo Shawn Daniels

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16107 Issued in MD

Practice address

4227 Dunwood Ter
Burtonsville, MD 20866-1323

Phone

(443) 858-1383

NPI assigned

Jun 19, 2012

Last updated

Mar 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Daniels Dynamic Therapy and Consulting , LLC

  • Clinical Social Worker
  • Burtonsville, MD
  • NPI 1366142853
  NPD Authorized official

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677888000000",
    "number": "1790048361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4227 DUNWOOD TER",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661323",
            "telephone_number": "443-858-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4227 DUNWOOD TER",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208661323",
            "telephone_number": "443-858-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "OMOTAYO",
        "middle_name": "SHAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2023-03-04",
        "certification_date": "2023-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC200001844",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904014336",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "16107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Joseph Craig, LCSW/CLINICAL
• Christopher Albert Crutchfield, PH.D.
• Raymond Andrew Custis
• Mary Elizabeth D'Amato, LMT
• Daniels Dynamic Therapy and Consulting , LLC
• Raju Datla
• Sherylin Denise Davis, OTR/L
• William Davis
• DC Multicultural Counseling Center LLC (Mental Health Counseling)
• Shanelle Debraux, PHARMD

• Clinical Social Worker in Burtonsville, MD
• Providers in Burtonsville, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2023; 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.