JEFF WILLIAM SHIVELY (NPI# 1376782961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376782961 |
| Entity Type | Individual |
| Full Name | JEFF WILLIAM SHIVELY |
| Credential | LICSW |
| Practice Address |
12805 Highway 55 Suite 200 Plymouth MN 55441-3859 |
| Practice Telephone | 6127230408 |
| Practice Fax Number | 7632105379 |
| Mailing Telephone | 6127230408 |
| Mailing Fax Number | 7632105379 |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2013-03-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
18053 | MN | Behavioral Health & Social Service Providers |
| Street Address |
12805 HIGHWAY 55 SUITE 200 |
| City | PLYMOUTH |
| State | MN |
| Zip Code | 55441-3859 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699708396 | Soteria Family Health Center | Clinic/Center | 12805 Highway 55, Suite 111, Plymouth, MN 55441-3859 | 2006-07-08 |
| 1093261521 | Navigating Changes LLC | Counselor | 12805 Highway 55, Suite 402, Plymouth, MN 55441-3859 | 2016-08-25 |
| 1194101212 | Autism Family Therapy Inc | Marriage & Family Therapist | 12805 Highway 55, Suite 402, Plymouth, MN 55441-3859 | 2015-07-31 |
| 1831525435 | Ann Elizabeth Huber | Advanced Practice Midwife | 12805 Highway 55, Suite 111, Plymouth, MN 55441-3859 | 2013-09-16 |
| 1366874299 | Jeff Shively, Msw, Licsw | Social Worker | 12805 Highway 55, Suite 200, Plymouth, MN 55441-3880 | 2013-08-02 |
| 1245437573 | Kristin Carpenter | Massage Therapist | 12805 Highway 55, Suite 210, Plymouth, MN 55441-3859 | 2007-06-29 |
| 1558491852 | Sherri Ann Rauen | Massage Therapist | 12805 Highway 55, Suite 208, Plymouth, MN 55441-3859 | 2007-03-06 |
| 1497820039 | Minnesota Psychological Resources | Counselor | 12805 Highway 55, Suite 211, Plymouth, MN 55441-3859 | 2006-11-21 |
| 1659446276 | David Burdette Mellberg | Psychologist | 12805 Highway 55, Suite 211, Plymouth, MN 55441-3859 | 2006-11-21 |
| 1679647531 | Kris Chaffee-bates | Counselor | 12805 Highway 55, Suite 211, Plymouth, MN 55441-3859 | 2006-11-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689190019 | The Recovery Clinic LLC | Clinic/Center | 9800 Shelard Pkwy Ste 215, Plymouth, MN 55441 | 2017-08-17 |
| 1356887186 | Katherine Marlow Bell | Dentist | 2805 Campus Dr Ste 245, Plymouth, MN 55441 | 2017-01-18 |
| 1083069538 | Mercade Waldon | Home Health Aide | 3501 Xenium Lane, Plymouth, MN 55441 | 2016-05-03 |
| 1346645538 | Phs Westhealth, Inc | Skilled Nursing Facility | 2775 Campus Drive North, Plymouth, MN 55441 | 2014-10-30 |
| 1427453125 | Samuel David Fine | Pharmacist | 4070 Goldenrod Ln, Plymouth, MN 55441 | 2014-10-24 |
| 1548672538 | Scott Aaron Schmidt | Dentist | 2720 Annapolis Circle N, Suite A, Plymouth, MN 55441 | 2014-05-23 |
| 1831498633 | Comforide Transportation Services LLC | Non-emergency Medical Transport (VAN) | 9730 37th Pl N Suite 201, Plymouth, MN 55441 | 2011-03-18 |
| 1255669271 | Tammy Kae Mehlhaus | Physician Assistant | 2855 Campus Drive, Suite 570, Plymouth, MN 55441 | 2009-12-02 |
| 1164758199 | Stephen P. Boger, Dds, Pa | Dentist | 2720 Annapolis Circle, Suite A, Plymouth, MN 55441 | 2009-10-27 |
| 1093908360 | Endodontic Professionals Pa Plymouth Endodontics | Dentist | 3401 Hwy 169 N, Plymouth, MN 55441 | 2007-08-21 |
| Find all providers in zip 55441 | ||||
| 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] |
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| 1649888637 | Look Within Counseling LLC | Social Worker | 1098 Ann Arbor Rd W # 588, Plymouth, MI 48170-2129 | 2020-07-16 |
| 1982236808 | Resilience Coach, LLC | Social Worker | 705 S Main St Ste 101b, Plymouth, MI 48170-1060 | 2020-02-08 |
| 1275178436 | Jennifer A Abraham | Social Worker | 135 Rocky Hill Rd, Plymouth, MA 02360-5524 | 2019-11-12 |
| 1073164349 | Alishia Ebel Lmsw LLC | Social Worker | 496 W Ann Arbor Trl Ste 106, Plymouth, MI 48170-6262 | 2019-09-26 |
| 1366926206 | Elizabeth Paronich | Social Worker | 9 Hibiscus Ln, Plymouth, MA 02360-5344 | 2018-09-17 |
| 1992288609 | Robert Eisenstein | Social Worker | 15 Gallagher Dr, Plymouth, MA 02360-1407 | 2018-09-09 |
| 1306329271 | Patricia Jane Whitaker | Social Worker | Masac-plymouth, 1 Bumps Pond Road, Plymouth, MA 02360 | 2018-09-07 |
| 1588146914 | Alicia Mae Donahue | Social Worker | 15805 26th Ave N Unit D, Plymouth, MN 55447 | 2018-09-01 |
| 1003398645 | Judith A Gonsalves | Social Worker | 36 Cordage Park Cir Ste 326, Plymouth, MA 02360-7320 | 2018-08-30 |
| Find all providers in PLYMOUTH | ||||
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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.