Individual provider Active NPI

Shannon Nicole Stockman

  • Clinical Social Worker
  • Wheat Ridge, CO
National Provider Identifier
1790565935
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09927035 Issued in CO
Practice address
11597 W 38TH PL
Wheat Ridge, CO 80033-3803
Phone
(303) 506-8298
NPI assigned
Oct 4, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 09927035 CO Primary

Addresses

Primary practice location

11597 W 38TH PL
Wheat Ridge, CO 80033-3803

Mailing address

11597 W 38TH PL
Wheat Ridge, CO 80033-3803
Phone (303) 506-8298

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
09927035COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1790565935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11597 W 38TH PL",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800333803",
            "telephone_number": "303-506-8298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11597 W 38TH PL",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800333803",
            "telephone_number": "303-506-8298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKMAN",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09927035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheat Ridge, CO

Sources for this page

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