SHADOW BACKUS (NPI# 1962057463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962057463 |
| Entity Type | Individual |
| Full Name | SHADOW BACKUS |
| Credential | LCSW, LMT |
| Practice Address |
34 Schroeder Ct Madison WI 53711-2526 |
| Mailing Address |
1041 Galway Ave Waunakee WI 53597-8956 |
| Practice Telephone | 6084093400 |
| Mailing Telephone | 6084093400 |
| Enumeration Date | 2019-08-02 |
| Last Update Date | 2020-02-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
6526-123 | WI | Behavioral Health & Social Service Providers |
| Street Address |
34 SCHROEDER CT |
| City | MADISON |
| State | WI |
| Zip Code | 53711-2526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720017973 | Surgi Center of Greater Madison, LLC | Clinic/Center | 34 Schroeder Ct, Ste 100, Madison, WI 53711-2525 | 2006-07-01 |
| 1730572843 | Surgi Center of Greater Madison, LLC | Durable Medical Equipment & Medical Supplies | 34 Schroeder Ct, Suite 100, Madison, WI 53711-2526 | 2015-03-13 |
| 1356734438 | Advanced Pain Management Sc | Durable Medical Equipment & Medical Supplies | 34 Schroeder Ct, Madison, WI 53711-2526 | 2015-03-12 |
| 1841446028 | Advanced Pain Management | Specialist | 34 Schroeder Ct, Madison, WI 53711-2525 | 2008-08-07 |
| 1265639272 | Sarah B. Hittner | Physician Assistant | 34 Schroeder Ct, Ste 100, Madison, WI 53711-2525 | 2007-07-02 |
| 1114138112 | Marilee J. Bell | Nurse Practitioner | 34 Schroeder Ct, Ste 100, Madison, WI 53711-2525 | 2007-05-24 |
| 1912026386 | Kim Litwack | Nurse Practitioner | 34 Schroeder Ct, Suite 100, Madison, WI 53711-2525 | 2007-03-28 |
| 1003824269 | Karyn Evelyn Moehring | Dietitian, Registered | 34 Schroeder Ct, Suite 230, Madison, WI 53711-2526 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487296307 | Exact Sciences Laboratories, LLC | Clinical Medical Laboratory | 650 Forward Drive, Madison, WI 53711 | 2019-10-11 |
| 1508417916 | Cassandra D Pasquariello | Psychologist | Department of Athletics, 1440 Monroe Street, Madison, WI 53711 | 2019-09-26 |
| 1972161628 | Leah Bastian | Marriage & Family Therapist | 2935 S Fish Hatchery Rd # 244, Madison, WI 53711 | 2019-05-29 |
| 1457810673 | Leah Smith | Specialist/Technologist | 1436 Monroe Street, Madison, WI 53711 | 2019-03-18 |
| 1669942249 | Patrick Soltvedt Bohn | Physician Assistant | 1034 Waban Hill, Madison, WI 53711 | 2018-11-27 |
| 1760975395 | Alysha Rolli | Dentist | 2945 Triverton Pike Dr, Fitchburg, WI 53711 | 2018-06-08 |
| 1265922561 | Farence Rogers | Student in an Organized Health Care Education/Training Program | 1475 Engineering Dr. Madison, Madison, WI 53711 | 2018-05-14 |
| 1588015358 | Kristen Siskovich | Speech-Language Pathologist | 2927 Fish Hatchery Rd., Fitchburg, WI 53711 | 2016-06-23 |
| 1598132383 | Shari Eberhardt | Nurse Practitioner | Journey Mental Health Center, 25 Kessel Ct, Madison, WI 53711 | 2015-08-27 |
| 1649646506 | Oak Park Place of Nakoma, LLC | Skilled Nursing Facility | 4327 Nakoma Road, Madison, WI 53711 | 2015-08-14 |
| Find all providers in zip 53711 | ||||
| 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 |
|---|---|---|---|---|
| 1306446257 | Richard Harry Goldberg | Social Worker | 1514 Wood Ln, Madison, WI 53705-1457 | 2020-10-29 |
| 1710586219 | Megan Beckler | Social Worker | 49 Kessel Ct Bldg 25, Madison, WI 53711-6200 | 2020-10-26 |
| 1003436759 | Creating Space, LLC | Social Worker | 1915 Winnebago St Ste 101, Madison, WI 53704-5322 | 2020-04-23 |
| 1871143370 | Cecilia Goldschmidt | Social Worker | 2445 Darwin Rd Ste 15, Madison, WI 53704-3116 | 2019-09-17 |
| 1699321760 | Golden Vibes Counseling Center | Social Worker | 303 S Paterson St, Madison, WI 53703-4528 | 2019-08-14 |
| 1285293530 | Bianca Whitney | Social Worker | 506 Charles Ln, Madison, WI 53711-1312 | 2019-06-11 |
| 1598322505 | Judith Coursen Stevens | Social Worker | 147 Durham Road, Madison, CT 06443-1262 | 2019-05-24 |
| 1750840575 | Kimberly Michelle Horton | Social Worker | 102 Crabapple Grv, Madison, MS 39110-7098 | 2019-03-19 |
| 1497211387 | Latasha Monique Williams | Social Worker | Patriot Place (va), 314 Williams Avenue, Ste. 100, Madison, TN 37115 | 2019-02-15 |
| 1528536976 | Emily Elizabeth Morris | Social Worker | 4002 Nakoosa Trl, Madison, WI 53714-1314 | 2018-11-04 |
| Find all providers in MADISON | ||||
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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.