John Lark Shasteen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-1285 Issued in AR

Practice address

1803 SW Regional Airport Blvd Ste 5
Bentonville, AR 72712-8792

Phone

(479) 876-8626

Fax

(479) 876-8636

NPI assigned

Jul 7, 2006

Sex

Male

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

Practice roles

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.

• Ask Wellness Center,LLC

  • Clinical Social Worker
  • Bentonville, AR
  • NPI 1972967412
  NPD (past)
• Ozark Guidance Center, Inc

  • Family Medicine Physician
  • Springdale, AR
  • NPI 1659945194
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1871525071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 SW REGIONAL AIRPORT BLVD STE 5",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727128792",
            "telephone_number": "479-876-8626",
            "fax_number": "479-876-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 SW REGIONAL AIRPORT BLVD STE 5",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727128792",
            "telephone_number": "479-876-8626",
            "fax_number": "479-876-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHASTEEN",
        "first_name": "JOHN",
        "middle_name": "LARK",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "C-1285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER #",
            "identifier": "5S196",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn M Shaffer, LPC
• Shamsul Alam MD PA (The Kidney Clinic)
• Tiffany Lynn Shanahan, NP-C
• Shanna M. Molina MD PLLC
• Shannon Candid Arkansas, P.a.
• Ayesha Shaukat, RPH
• Kerri Shaw, M.S., CCC-SLP
• Lisa Shaw
• Elizabeth Anne Shelby, M.S., CCC-SLP
• Janiah Shell

• Clinical Social Worker in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.