Individual provider Active NPI

Deborah Elizabeth Shope, LICSW

  • Clinical Social Worker
  • Lebanon, NH
National Provider Identifier
1881690840
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1283 Issued in NH
Practice address
1 Court St Ste 220
Lebanon, NH 03766-1358
Phone
(603) 727-2562
NPI assigned
Jun 23, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 089-0000860 VT
Clinical Social Worker 1041C0700X 1283 NH Primary

Addresses

Primary practice location

1 Court St Ste 220
Lebanon, NH 03766-1358

Mailing address

1 Court St Ste 220
Lebanon, NH 03766-1358
Phone (603) 727-2562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051018000758 NH Practitioner - Clinical Social Worker 2466409925 Practice locations: Lebanon, NH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

27 Bank St
Suite 1
Lebanon, NH 03766-1793
Phone (603) 727-2562

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1283NHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Affirm Medical Group PLLC PastSince May 27, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1881690840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COURT ST STE 220",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661358",
            "telephone_number": "603-727-2562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COURT ST STE 220",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661358",
            "telephone_number": "603-727-2562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOPE",
        "first_name": "DEBORAH",
        "middle_name": "ELIZABETH",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0000860",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.