Shalyn Danielle Fava, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW03016 Issued in RI

Practice address

420 Scrabbletown Rd Ste a
North Kingstown, RI 02852-3638

Phone

(401) 268-5333

Fax

(855) 268-5333

NPI assigned

Oct 30, 2018

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 RI

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

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.

• South County Psychiatry LLC

  • Psychiatry Physician
  • North Kingstown, RI
  • NPI 1003454034

  Clinical

  Medicare reassignment NPD
• Shalyn Coleman Licsw LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • East Greenwich, RI
  • NPI 1275284093
  NPD
• Inner You LLC

  • Clinical Social Worker
  • Warwick, RI
  • NPI 1225464209
  NPD (past)
• The Inner You

  • Clinical Social Worker
  • Warwick, RI
  • NPI 1386177566
  NPD (past)

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1972070761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 SCRABBLETOWN RD STE A",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028523638",
            "telephone_number": "401-268-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 SCRABBLETOWN RD STE A",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028523638",
            "telephone_number": "401-268-5333",
            "fax_number": "855-268-5333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4372 Post Rd",
            "address_purpose": "LOCATION",
            "city": "East Greenwich",
            "state": "RI",
            "postal_code": "028184123",
            "country_code": "US",
            "telephone_number": "401-496-9287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAVA",
        "first_name": "SHALYN",
        "middle_name": "DANIELLE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "ISW03016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthur Edward Erskine III, LMHC
• George Michael Escobar, CDOE
• Face the Sun LLC
• Kealan Winters Faerber, PTA
• Nicole A Faison
• John P Femino, M.D.
• Jessica Marie Ferrol, LMHC
• Kelley E Finch, LICSW
• Shauna Finley, PH.D.
• Dorothy Carrie Fishman, PHD

• Clinical Social Worker in North Kingstown, RI
• Providers in North Kingstown, RI by specialty
• Clinical Social Worker in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.