Shawn Dylan Dennis, LCSW
Individual provider Active NPI Clinical Social Worker · Mammoth Spring, AR
NPI 1871070565 · NPPES record last updated Mar 25, 2024
Key facts
- NPI
- 1871070565
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 8780-C (AR)
- Practice address
- 410 Goldsmith Ave
Mammoth Spring, AR 72554-8045 - Phone
- (417) 280-1247
- Fax
- (870) 341-6242
- NPI assigned
- Jul 25, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8780-C | AR | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bokker Enterprises, Inc. | Past |
Accepting new patients | |
| Bokker Enterprises, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8780-C | AR | Yes |
| Mental Health Counselor | 101YM0800X | AR |
Addresses
Primary practice location
410 Goldsmith Ave
Mammoth Spring, AR 72554-8045
Mailing address
10282 Private Road 8829
West Plains, MO 65775-9400
Phone (417) 280-1247
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 232264719 | Medicaid | AR |
Other names
- Dylan Dennis
Other providers in Mammoth Spring, AR
- Charlotte Featherston Counseling Agency, LLC
- Michael J Clark
- Sarah Clark
- Christopher D Cochran
- Shawn C Dennis
- Family Health Care
- Family Health Care LLC
- Family Health Care, LLC
- Charlotte Ann Featherston
- Gregory Ross Fuller
All providers in Mammoth Spring, AR · Clinical Social Worker in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.