Active NPI
Shane William Walker, LLCMSW
- Clinical Social Worker
- Harrison, MI
National Provider Identifier
1972029262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801101639
- Practice address
- 789 N Clare Ave
Harrison, MI 48625-8250 - Phone
- (989) 539-2141
- NPI assigned
- Aug 17, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801101639 | MI | Primary |
Addresses
Primary practice location
789 N Clare Ave
Harrison, MI 48625-8250
Mailing address
1408 Cummer St
Cadillac, MI 49601-1769
Phone (231) 429-3870
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801101639 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546387200000",
"number": "1972029262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1408 CUMMER ST",
"city": "CADILLAC",
"state": "MI",
"postal_code": "496011769",
"telephone_number": "231-429-3870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "789 N CLARE AVE",
"city": "HARRISON",
"state": "MI",
"postal_code": "486258250",
"telephone_number": "989-539-2141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "SHANE",
"middle_name": "WILLIAM",
"credential": "LLCMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-08-17",
"last_updated": "2019-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801101639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harrison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.