Individual provider Active NPI

Shalean Kemp

  • Social Worker
  • Garfield Heights, OH
National Provider Identifier
1972753630
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.0600074 Issued in OH
Practice address
12820 Darlington Ave
Garfield Heights, OH 44125-3759
Phone
(216) 254-4577
NPI assigned
Sep 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.1600893 OH
Clinical Social Worker 1041C0700X 6801105366 MI
Social Worker 104100000X S.0600074 OH Primary

Addresses

Primary practice location

12820 Darlington Ave
Garfield Heights, OH 44125-3759

Mailing address

12820 Darlington Ave
Garfield Heights, OH 44125-3759
Phone (216) 254-4577

Other identifiers 3

IdentifierTypeStateIssuer
I.1600893OtherOHLICENSED INDEPENDENT SOCIAL WORKER
6801105366OtherMILICENSED CLINICAL SOCIAL WORKER
S.0600074OtherOHCOUNSELOR

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

LicenseStateTypeSpecialty
S.0600074OHMDSocial Worker
6801105366MIMDClinical Social Worker
I.1600893OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Resources Past Accepting new patients
Recovery Resources Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1972753630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12820 DARLINGTON AVE",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441253759",
            "telephone_number": "216-254-4577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12820 DARLINGTON AVE",
            "city": "GARFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441253759",
            "telephone_number": "216-254-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEMP",
        "first_name": "SHALEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1600893",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801105366",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.0600074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED INDEPENDENT SOCIAL WORKER",
            "identifier": "I.1600893",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CLINICAL SOCIAL WORKER",
            "identifier": "6801105366",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COUNSELOR",
            "identifier": "S.0600074",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garfield Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.