Individual provider Active NPI

Sandra E Shuty, LCSW

  • Clinical Social Worker
  • Pompano Beach, FL
National Provider Identifier
1972954378
Registry record updated Jun 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12863 Issued in FL
Practice address
180 Cypress Club Dr
Apt 805
Pompano Beach, FL 33060-4773
Phone
(724) 799-1761
NPI assigned
Jun 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW12863 FL Primary

Addresses

Primary practice location

180 Cypress Club Dr
Apt 805
Pompano Beach, FL 33060-4773

Mailing address

180 Cypress Club Dr
Apt 805
Pompano Beach, FL 33060-4773
Phone (724) 799-1761

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
SW12863FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466985600000",
    "number": "1972954378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 CYPRESS CLUB DR",
            "address_2": "APT 805",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330604773",
            "telephone_number": "724-799-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 CYPRESS CLUB DR",
            "address_2": "APT 805",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330604773",
            "telephone_number": "724-799-1761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTY",
        "first_name": "SANDRA",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2016-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2016; 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.