Active NPI
Shawnese Marie Walker Worthem, MASTERS OF SOCIAL WO
- Clinical Social Worker
- Eastpointe, MI
National Provider Identifier
1790908283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801057042
- Practice address
- 18301 E 8 Mile Rd
Suite 104
Eastpointe, MI 48021-3212 - Phone
- (586) 362-8955
- NPI assigned
- Apr 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801057042 | MI | Primary |
Addresses
Primary practice location
18301 E 8 Mile Rd
Suite 104
Eastpointe, MI 48021-3212
Mailing address
28475 Greenfield Rd
Suite 207
Southfield, MI 48076-3034
Phone (248) 424-9778
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 800897615 | Other | MI | BLUE CROSS BLUE SHIELD OF |
| 11557119 | Other | MI | CAQH |
| 60001536 | Other | MI | MAGELLAN |
| 0007980763 | Other | MI | AETNA |
| 226708 | Other | MI | VALUE OPTIONS |
Other names 1
- Shawnese Walker
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376956800000",
"number": "1790908283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28475 GREENFIELD RD",
"address_2": "SUITE 207",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480763034",
"telephone_number": "248-424-9778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18301 E 8 MILE RD",
"address_2": "SUITE 104",
"city": "EASTPOINTE",
"state": "MI",
"postal_code": "480213212",
"telephone_number": "586-362-8955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER WORTHEM",
"first_name": "SHAWNESE",
"middle_name": "MARIE",
"credential": "MASTERS OF SOCIAL WO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-11",
"last_updated": "2013-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801057042",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF",
"identifier": "800897615",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11557119",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "60001536",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0007980763",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "226708",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SHAWNESE",
"last_name": "WALKER",
"credential": "LMSW",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Eastpointe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.