MR. SHAWN HARRIS MUTHERSBAUGH (NPI# 1063404143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063404143 |
| Entity Type | Individual |
| Full Name | MR. SHAWN HARRIS MUTHERSBAUGH |
| Credential | LCSW-R |
| Practice Address |
120 Defreest Dr. 175 Troy NY 12180 |
| Practice Telephone | 5183906890 |
| Practice Fax Number | 5183746898 |
| Mailing Telephone | 5183906890 |
| Mailing Fax Number | 5183746898 |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2019-09-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | R032125 | NY | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
R032125 | NY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01645743 | 05 |
| Street Address |
120 DEFREEST DR., 175 |
| City | TROY |
| State | NY |
| Zip Code | 12180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528616232 | Gwendolyn Eve Guarino | Massage Therapist | Lux, 207 River St, Troy, NY 12180 | 2019-08-27 |
| 1568020857 | Shelby Mara Quintal | Counselor | 7 Collins Ave, Troy, NY 12180 | 2019-05-31 |
| 1881179646 | St. Peter's Health Partners Medical Associates, P.C. | Family Medicine | 2109 15th Street, Troy, NY 12180 | 2018-09-27 |
| 1104354315 | Karen Lynm Vincent | Licensed Practical Nurse | 830 Hoosick Rd Apt 1, Troy, NY 12180 | 2017-06-01 |
| 1740728013 | Upstate Physician Services, PC | Specialist | 2001 5th Avenue, Suite 110, Troy, NY 12180 | 2017-02-07 |
| 1205373263 | Tsu Han Poh | Pharmacist | 204 Washington Street, Apt C1, Troy, NY 12180 | 2017-01-27 |
| 1053760546 | Linda Pierre | Religious Nonmedical Nursing Personnel | 1680 Tibbits Ave, Troy, NY 12180 | 2016-06-06 |
| 1518312925 | Matthew Pittelli | Student in an Organized Health Care Education/Training Program | 83 Lockrow Rd, Troy, NY 12180 | 2016-05-04 |
| 1780045765 | Tara Michelle Miller | Hearing Instrument Specialist | 2000 6th Avenue, Troy Towers, Bldg. B, 1st Floor, Troy, NY 12180 | 2016-03-17 |
| 1326410937 | Seton Health System, Inc. | Physician Assistant | 1401 Massachusetts Avenue, Troy Internal Medicine, Troy, NY 12180 | 2015-10-22 |
| Find all providers in zip 12180 | ||||
| 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 |
|---|---|---|---|---|
| 1629676275 | Chester Counseling LLC | Social Worker | 2833 Crooks Rd Ste 104, Troy, MI 48084-4732 | 2020-10-15 |
| 1053922344 | Dejuana Mcgee | Social Worker | 555 Kirts Blvd Apt 9, Troy, MI 48084-4105 | 2020-08-11 |
| 1780220939 | Meagan Hahn | Social Worker | 2032 E Square Lake Rd Ste 200d, Troy, MI 48085-3315 | 2019-11-22 |
| 1679124523 | Rachel K Garrett | Social Worker | 201 Randolph St, Troy, AL 36081-4529 | 2019-09-23 |
| 1801440367 | Ashley Kays Zair, Lmsw, LLC | Social Worker | 3290 W. Big Beaver Rd., Suite 188, Troy, MI 48084-2915 | 2019-08-01 |
| 1255984860 | Inner Guidance Counseling Center, Pllc | Social Worker | 625 E Big Beaver Rd Ste 104, Troy, MI 48083-1413 | 2019-07-23 |
| 1205499100 | Kathleen A Becker Lmsw LLC | Social Worker | 650 E Big Beaver Rd Ste B, Troy, MI 48083-1432 | 2019-04-16 |
| 1063980563 | Rapha Counseling | Social Worker | 3668 Livernois Rd Ste 420, Troy, MI 48083-5035 | 2018-11-02 |
| 1104303734 | Samantha Voss | Social Worker | 575 E Big Beaver Rd Ste 210, Troy, MI 48083-1301 | 2018-07-26 |
| 1629555677 | Christine Ann Waller | Social Worker | 125 Fox Harbor Dr, Troy, OH 45373-1088 | 2018-07-23 |
| Find all providers in TROY | ||||
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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.