Shaesha Shoulders, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801107639 Issued in MI

Practice address

21 N Main St
Mount Clemens, MI 48043-5613

Phone

(586) 404-4449

Fax

(586) 501-1664

NPI assigned

May 13, 2021

Last updated

May 13, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1942874060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1571 S BASSETT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482171642",
            "telephone_number": "313-989-6746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 N MAIN ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480435613",
            "telephone_number": "586-404-4449",
            "fax_number": "586-501-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOULDERS",
        "first_name": "SHAESHA",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801107639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "TigerConnect",
            "affiliation": "N",
            "address_1": "21 N Main St",
            "city": "Mount Clemens",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480435613",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicole Marie Shields, PA-C
• Tracy Shifflett, NP
• Kristina Nicole Shirley
• Yordanos Lakachew Shita, DO
• Sheryl Lynn Shoebottom, ACNP-BC
• Peter Siclari, MD
• Seth Michael Signs, DO
• Alexandrea Simmons
• Claire Susan Simon, CRNA
• Stephanie Sitek, LPTA

• Clinical Social Worker in Mount Clemens, MI
• Providers in Mount Clemens, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; 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.