Mary Ann Shinnick, LISW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

I04569 Issued in NM

Practice address

4004 Carlisle Blvd NE
Suite J
Albuquerque, NM 87107-4565

Phone

(505) 459-7565

Fax

(505) 294-5887

NPI assigned

Sep 13, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366848000000",
    "number": "1821083130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 CARLISLE BLVD NE",
            "address_2": "SUITE J",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074565",
            "telephone_number": "505-459-7565",
            "fax_number": "505-294-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 CARLISLE BLVD NE",
            "address_2": "SUITE J",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871074565",
            "telephone_number": "505-459-7565",
            "fax_number": "505-294-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINNICK",
        "first_name": "MARY ANN",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2013-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "I04569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100096",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter C. Shin, M.D.
• Sang O Shin, MD
• Mara Esther Shindell, D.D.S.
• Amal Shine, MD
• Phyllis Shingle, LCSW
• Justin Lane Shipler
• Behjat Shirazi, LPCC
• Shirley M. Turco, L.L.C.
• Denise Shirley, LCSW
• Karen Shirley, SLP

• Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.

Verify at the official NPI Registry.