Shane Desmith, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S.2309105 Issued in OH

Practice address

1500 McKinley Ave
Niles, OH 44446-3718

Phone

(330) 953-3300

NPI assigned

Dec 8, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/wecaremoreohio/r4/

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.

• First Step Recovery of Warren LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Warren, OH
  • NPI 1255736450
  NPD (past)
• First Step Recovery of Warren LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Warren, OH
  • NPI 1346120979

  Substance Abuse Rehabilitation Facility

  NPD (past)

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1841705191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5760 PATRIOT BLVD",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445151170",
            "telephone_number": "330-953-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 MCKINLEY AVE",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444463718",
            "telephone_number": "330-953-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1051 N Canfield Niles Rd",
            "address_purpose": "LOCATION",
            "city": "Austintown",
            "state": "OH",
            "postal_code": "445151110",
            "country_code": "US",
            "telephone_number": "800-262-3742",
            "fax_number": "800-816-9684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESMITH",
        "first_name": "SHANE",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-08",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "0001988",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.2309105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark J Demalio, DC
• Tyler Dempsey
• Briana Dent
• Dental Express Kids Niles Michael R. Griesmer DDS LLC
• Kristen Desantis, RPH
• Lindsay Erin Devecchio, LPC
• Madison Devita
• Hannah Marie Dewalt
• Tyler Diaz
• Virginia Dinh, RPH

• Clinical Social Worker in Niles, OH
• Providers in Niles, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.