SHANNON DEXTER PETROVICH (NPI# 1104374255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104374255 |
| Entity Type | Individual |
| Full Name | SHANNON DEXTER PETROVICH |
| Credential | LCSW, LISAC |
| Practice Address |
5855 N Kolb Rd Unit 4208 Tucson AZ 85750-0991 |
| Practice Telephone | 5209094740 |
| Mailing Telephone | 5209094740 |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2016-09-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LISAC-1365 | AZ | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LCSW-4024 | AZ | Behavioral Health & Social Service Providers |
| Street Address |
5855 N KOLB RD UNIT 4208 |
| City | TUCSON |
| State | AZ |
| Zip Code | 85750-0991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972125490 | Arizona Medical Specialty Group, LLC | Nurse Practitioner | 5590 E River Rd., Suite 101, Tucson, AZ 85750 | 2020-05-07 |
| 1962858936 | Honu Counseling Pllc | Community/Behavioral Health | 5855 North Kolb Road Unit 4208, Tucson, AZ 85750 | 2016-05-10 |
| 1750653341 | Patricia Jean Heese | Occupational Therapist | 5410 N Grey Moutain Tr, Tucson, AZ 85750 | 2012-01-30 |
| 1184911257 | Collaborative Associates In Surgical Assisting | Registered Nurse | 5601 E. Camino Del Celador, Tucson, AZ 85750 | 2011-07-08 |
| 1841468584 | Shelly Kay Surber | Nurse Practitioner | Minute Clinic, 6895 E Sunrise Dr., Tucson, AZ 85750 | 2008-02-15 |
| 1982788121 | Laurie Beth Weston | Psychiatry & Neurology | 7921 E Presidio Road, Tucson, AZ 85750 | 2006-10-24 |
| 1518050624 | David Stuart Thompson | Psychiatry & Neurology | 5661 East Shadow View Ct, Tucson, AZ 85750 | 2006-10-02 |
| 1043250541 | Cathy Evelyn Wayand | Registered Nurse | 6890 E Sunrise Drive Ste 120 #223, Tucson, AZ 85750 | 2006-06-07 |
| 1144206806 | John Daniel Mcarthur | Radiology | 5965 N Sabino Shadow Ln, Tucson, AZ 85750 | 2005-12-15 |
| 1972599181 | Howard Hunter Yost | Psychiatry & Neurology | 5520 N Waterfield Dr, Tucson, AZ 85750 | 2005-09-22 |
| Find all providers in zip 85750 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669070710 | Erica Rhea Wagner | Social Worker | 4873 E Cooper St, Tucson, AZ 85711-3617 | 2020-10-12 |
| 1053928648 | Elizabeth Sarah Kieding | Social Worker | 4732 E Calle Elegante, Tucson, AZ 85718-3733 | 2020-09-28 |
| 1386259778 | Yolanda Jeli | Social Worker | 1701 W Saint Marys Rd Ste 117, Tucson, AZ 85745-2621 | 2020-09-11 |
| 1689282097 | Marcus Aurelius De Volder | Social Worker | 8110 E Speedway Blvd Apt 8391, Tucson, AZ 85710-1782 | 2020-07-21 |
| 1336766641 | Jamie Lakin | Social Worker | 470 W Roger Rd Ste 110, Tucson, AZ 85705-2679 | 2020-07-02 |
| 1356961973 | Jillian A Stein-seroussi | Social Worker | 5400 E Williams Blvd Apt 12207, Tucson, AZ 85711-7486 | 2020-04-23 |
| 1124648175 | Deborah Lorraine Mack | Social Worker | 9950 N Camino De Oeste, Tucson, AZ 85742-9119 | 2020-04-20 |
| 1376163543 | Strategic Healing LLC | Social Worker | 245 S Bryant Ave, Tucson, AZ 85711-4122 | 2020-04-17 |
| 1811526841 | Jessica Belter | Social Worker | 3009 E Elm St # 1, Tucson, AZ 85716-3124 | 2020-04-02 |
| 1700425436 | Shannon N Barefield | Social Worker | 48 N Tucson Blvd Ste 100, Tucson, AZ 85716-4756 | 2019-12-28 |
| Find all providers in TUCSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.