KENDRA SHACKELTON (NPI# 1629355425) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629355425 |
| Entity Type | Individual |
| Full Name | KENDRA SHACKELTON |
| Credential | LMSW |
| Practice Address |
221 S Main St Royal Oak MI 48067-2653 |
| Mailing Address |
1252 Hendrickson Blvd Clawson MI 48017-2309 |
| Practice Telephone | 2483986459 |
| Practice Fax Number | 2486291432 |
| Mailing Telephone | 3137280166 |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2014-03-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
6801091837 | MI | Behavioral Health & Social Service Providers |
| Street Address |
221 S MAIN ST |
| City | ROYAL OAK |
| State | MI |
| Zip Code | 48067-2653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053827 | Rachel Ortega | Nurse Practitioner | 221 S Main St, Royal Oak, MI 48067-2653 | 2020-11-03 |
| 1750855169 | Theresa Ann Fox | Nurse Practitioner | 221 S Main St, Royal Oak, MI 48067 | 2019-01-18 |
| 1548706807 | Lisa Caffee | Nurse Practitioner | 221 S Main St, Royal Oak, MI 48067-2653 | 2017-01-11 |
| 1699225722 | Patricia Imai | Social Worker | 221 S Main St, Royal Oak, MI 48067-2653 | 2016-10-13 |
| 1982159646 | Sarah Tarbox-berry | Psychologist | 221 S Main St, Royal Oak, MI 48067-2653 | 2016-08-23 |
| 1386024487 | Kristy Marie Byerly | Nurse Practitioner | 221 S Main St, Royal Oak, MI 48067-2653 | 2015-06-03 |
| 1881016418 | Rachel Walsh | Social Worker | 221 S Main St, Suite 201, Royal Oak, MI 48067-2653 | 2014-01-16 |
| 1073817110 | Dawn Renee Fleck | Counselor | 221 S Main St, Suite 201, Royal Oak, MI 48067-2653 | 2011-01-04 |
| 1770805277 | Theresa Lambert | Nurse Practitioner | 221 S Main St, Suite 201, Royal Oak, MI 48067-2653 | 2010-02-24 |
| 1932343308 | Gwendolyn Michelle Pryor | Nurse Practitioner | 221 S Main St, Suite 201, Royal Oak, MI 48067-2653 | 2009-04-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922609072 | George Edward Khamis | Psychologist | 25600 Woodward Avenue, Suite 215, Royal Oak, MI 48067 | 2020-11-05 |
| 1205443751 | Crossover Health Medical Group | Clinic/Center | 424 E. 4th St, Suite 100, Royal Oak, MI 48067 | 2020-09-29 |
| 1750917811 | Sonia B Shah-gonzalez | Case Management | 830 E Fourth St, #1, Royal Oak, MI 48067 | 2020-03-19 |
| 1568022960 | Woodo Pharmacy LLC | Pharmacy | 909 E 11 Mile Rd, Royal Oak, MI 48067 | 2019-06-18 |
| 1093217564 | Sharon Diane Malinowski | Occupational Therapist | 4949 Coolidge Hwy Section E, Adult Neuro Ot, Royal Oak, MI 48067 | 2018-03-01 |
| 1962916569 | Nuch of Michigan Inc | Clinic/Center | 2140 E 12 Mile Rd, Royal Oak, MI 48067 | 2017-11-20 |
| 1629420179 | Christine Paige | Homeopath | 1112 Catalpa, Royal Oak, MI 48067 | 2016-07-08 |
| 1104277045 | Rppc Labs, LLC | Clinical Medical Laboratory | 26154 Woodward Ave Ste 5, Royal Oak, MI 48067 | 2016-06-22 |
| 1346606423 | Thomas Michalos | Counselor | 402 S. Lafayette, Royal Oak, MI 48067 | 2016-01-05 |
| 1508234212 | Valetta Aldridge | Registered Nurse | 28000 Woodward, Royal Oak, MI 48067 | 2015-09-11 |
| Find all providers in zip 48067 | ||||
| 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 |
|---|---|---|---|---|
| 1821607623 | Ariel Roberts | Social Worker | 123 S Main St Ste 100, Royal Oak, MI 48067-2627 | 2020-07-28 |
| 1124652938 | Human Kindness Trauma Psychotherapy LLC | Social Worker | 1710 E 12 Mile Rd Ste C, Royal Oak, MI 48073-4200 | 2020-03-02 |
| 1881233823 | Integrated Day Services and Rehabilitation LLC | Social Worker | 627 E 11 Mile Rd Ste 105, Royal Oak, MI 48067-1961 | 2019-12-21 |
| 1053954362 | Jodi Mollica | Social Worker | 628 E Parent Ave Ste 506, Royal Oak, MI 48067-3768 | 2019-10-21 |
| 1790249472 | Maryleigh King | Social Worker | 1510 E Lincoln Ave, Royal Oak, MI 48067-3402 | 2019-01-26 |
| 1477070274 | Nicholas John Zielke | Social Worker | 25600 Woodward Ave Ste 215, Royal Oak, MI 48067-0945 | 2017-08-23 |
| 1063868040 | Julie Ann Szczepanski | Social Worker | 907 Amelia Ave, Royal Oak, MI 48073-2758 | 2016-05-10 |
| 1497128169 | Steven Whitmore | Social Worker | 2824 Trafford Rd, Royal Oak, MI 48073-2909 | 2015-11-03 |
| 1770968588 | Susan Ann Dimarco | Social Worker | 522 E Hudson Ave, Royal Oak, MI 48067-3350 | 2015-07-22 |
| 1518364900 | Zhanna Rozenberg | Social Worker | 4115 Benjamin Ave Apt 8, Royal Oak, MI 48073-1858 | 2014-12-01 |
| Find all providers in ROYAL OAK | ||||
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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.