Heather Danielle Shipley, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15458 Issued in TN

Practice address

880 Rutledge Pike
Blaine, TN 37709-2317

Phone

(865) 933-4110

Fax

(865) 933-4729

NPI assigned

Feb 8, 2022

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

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1851045967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 SULPHUR SPRINGS RD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378135654",
            "telephone_number": "423-317-9344",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 RUTLEDGE PIKE",
            "city": "BLAINE",
            "state": "TN",
            "postal_code": "377092317",
            "telephone_number": "865-933-4110",
            "fax_number": "865-933-4729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 W Springdale Ave",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379175158",
            "country_code": "US",
            "telephone_number": "865-637-9711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIPLEY",
        "first_name": "HEATHER",
        "middle_name": "DANIELLE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "15458",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "15458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Michelle Roberts, RN
• Mary C Russell, APRN
• Robert Earl Saunders Jr., LICENSED CLINICAL SO
• Joshua Michael Schaff, BS
• Nancy Scott, LPN
• Marina Kathryne Smith
• Woojung Son, BA
• Kimberly Charlene Tanner
• Maria Carroll Vetter, BA
• Lauren Marie Watson

• All providers in Blaine, TN
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.