Shawn Marie Wellendorf, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

01492 Issued in IA

Practice address

925 Porter Ave
Des Moines, IA 50315-7235

Phone

(515) 287-9633

NPI assigned

Oct 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Mosaic Family Counseling Center IncGroup PAC ID 3577860501, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Mosaic Family Counseling Center, Inc.

  • Mental Health Counselor
  • Urbandale, IA
  • NPI 1417103649
  Medicare reassignment Care Compare group NPD
• Orchard Place

  • Psychiatric Residential Treatment Facility
  • Des Moines, IA
  • NPI 1245220938
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922189208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 PORTER AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503157235",
            "telephone_number": "515-287-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 PORTER AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503157235",
            "telephone_number": "515-287-9633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLENDORF",
        "first_name": "SHAWN",
        "middle_name": "MARIE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "01492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael D Welch, DC
• Mackenzie R Weldin, APRN
• Jeffrey J. Weldon, R.PH.
• Jenna M Weldon, RN
• Wellbrook Recovery Des Moines LLC
• Wellness Pattern Studio PLLC
• Amber Jeannette Wells, PMHNP
• Barbara Lorraine Wells, MSW
• Jill Wells
• John Michael Wells, DNP, CRNA

• Clinical Social Worker in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.