Shavette Shoulders, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW20653 Issued in FL

Practice address

3080 N Pace Blvd
Pensacola, FL 32505-5654

Phone

(850) 436-9831

NPI assigned

Jan 17, 2024

Sex

Female

Sole proprietor

Yes

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 FL

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.

• Cotler Healthcare & Development Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wellington, FL
  • NPI 1225075047
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical

  Medicare reassignment NPD
• Shine Medical Providers PC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1538894050
  NPD (past)

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1992566897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6995 WOODLEY DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325037238",
            "telephone_number": "850-375-9229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 N PACE BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325055654",
            "telephone_number": "850-436-9831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOULDERS",
        "first_name": "SHAVETTE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW20653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shoopak & Barry, PL (Orthodontic Specialists of Florida)
• Olivia White Shore, APRN
• Melissa Shores, C.PHT
• Joshua J Short, MD.PH.D
• Lillian Short
• April N. Showalter, PA-C
• Kenya Showers, MS
• Teresa Elizabeth Shrecengost
• Roshan Shrestha
• Jennifer Blanche Shue, APRN

• Clinical Social Worker in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.