Te'Andra Shockley, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21064 Issued in MD

Practice address

850 Oak St, Frederick, MD 21703
Frederick, MD 21703

Phone

(410) 946-6656

NPI assigned

Mar 7, 2022

Last updated

Mar 7, 2022By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1952058224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2039 SPRING RUN CIR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217026808",
            "telephone_number": "301-639-7632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 OAK ST, FREDERICK, MD 21703",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21703",
            "telephone_number": "410-946-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCKLEY",
        "first_name": "TE'ANDRA",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "21064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shim Wellness
• Kelly Ann Shine, M.D.
• Julia Shirima, REGISTERD NURSE
• Sarah S Shobert, OTR
• Megan Shockey-Miller
• Caitlin Erin Shoemaker, L.AC., M.AC.
• Lisa J Shoff, DMD
• Melanie Sholtis, PSY D
• Adedoyin Shonekan, M.D.
• Bobbi Lee Short, L.C.P.C.

• Clinical Social Worker in Frederick, MD
• Providers in Frederick, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.