Active NPI
Chad Shenk, PH.D.
- Clinical Psychologist
- Cincinnati, OH
National Provider Identifier
1972824910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6676
- Practice address
- 3333 Burnet Avenue
ML 5021
Cincinnati, OH 45229-3039 - Phone
- (513) 636-4225
- Fax
- (513) 636-2511
- NPI assigned
- Jun 14, 2010
- Sex
- Male
- Sole proprietor
- No
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 Psychologist | 103TC0700X | 6676 | OH | Primary |
Addresses
Primary practice location
3333 Burnet Avenue
ML 5021
Cincinnati, OH 45229-3039
Mailing address
3333 Burnet Avenue
ML 3015
Cincinnati, OH 45229-3039
Phone (513) 636-4336
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6676 | OH | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277683200000",
"number": "1972824910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 BURNET AVENUE",
"address_2": "ML 3015",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452293039",
"telephone_number": "513-636-4336",
"fax_number": "513-636-3677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 BURNET AVENUE",
"address_2": "ML 5021",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452293039",
"telephone_number": "513-636-4225",
"fax_number": "513-636-2511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHENK",
"first_name": "CHAD",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-14",
"last_updated": "2010-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "6676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.