SHANDYCE GWENDOLYN WILLIS (NPI# 1598077331) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598077331 |
| Entity Type | Individual |
| Full Name | SHANDYCE GWENDOLYN WILLIS |
| Practice Address |
130 Maple St Springfield MA 01103-2202 |
| Practice Telephone | 4137379544 |
| Mailing Telephone | 4137379544 |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2010-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | S13298161 | MA | Other Service Providers |
| Street Address |
130 MAPLE ST |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01103-2202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740252741 | Gina M Hughes | Clinical Nurse Specialist | 130 Maple St, Suite 205, Springfield, MA 01103 | 2006-02-03 |
| 1215542865 | Rosita S Medianero | Registered Nurse | 130 Maple St, Springfield, MA 01103-2202 | 2020-09-10 |
| 1730798711 | Megan Dow | Social Worker | 130 Maple St, Springfield, MA 01103-2202 | 2020-07-27 |
| 1477197895 | Pauline Ekajulo | Counselor | 130 Maple St, Springfield, MA 01103-2202 | 2019-10-29 |
| 1164082574 | Abigail Hakala | Counselor | 130 Maple St, Springfield, MA 01103-2202 | 2019-06-18 |
| 1154988657 | Carl Rohan Stewart | Counselor | 130 Maple St, Springfield, MA 01103-2202 | 2019-05-21 |
| 1033774344 | Justine Cynthia Penna | Counselor | 130 Maple St, Springfield, MA 01103-2202 | 2019-05-02 |
| 1699338343 | Devona Robinson-suttles | Counselor | 130 Maple St, Springfield, MA 01103-2202 | 2019-04-18 |
| 1730656513 | Nicholas Perez | Social Worker | 130 Maple St, Springfield, MA 01103-2202 | 2018-10-30 |
| 1790252575 | Sara Cote | Social Worker | 130 Maple St, Springfield, MA 01103-2202 | 2018-10-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336790609 | Mahmoud Al Homsi | Dentist | 41 Taylor St. 4th Fl, Springfield, MA 01103 | 2019-09-26 |
| 1427521749 | Pedro Cruz | Student in an Organized Health Care Education/Training Program | 95 Frank B Murray, Springfield, MA 01103 | 2019-01-09 |
| 1003325010 | Amber Lynn Chisholm | Counselor | 130 Maple St., Springfield, MA 01103 | 2017-09-21 |
| 1750737391 | Mande' Counseling | Community/Behavioral Health | 1365 Main St Suite 401, Springfield, MA 01103 | 2016-05-13 |
| 1528467248 | Amanda M Galloway | Physician Assistant | 1038-1050 Main St, Springfield, MA 01103 | 2014-08-19 |
| 1114326113 | Anne Marie Belinda | Nurse Practitioner | 1049 Main St., Springfield, MA 01103 | 2014-08-15 |
| 1538575295 | Sunrise Behavioral Health Clinic, LLC | Clinic/Center | 95 Frank B. Murray Street, Springfield, MA 01103 | 2014-07-02 |
| 1548675093 | Jessica Lynn Pasalacqua | Dietitian, Registered | 870 Main St., Springfield, MA 01103 | 2014-06-24 |
| 1003220443 | Ivan Rosario | Counselor | 1695 Main St Ste400, Springfield, MA 01103 | 2014-06-13 |
| 1275964769 | Leeandrew Rick Wilson | Counselor | 1695 Main St., Springfield, MA 01103 | 2013-12-09 |
| Find all providers in zip 01103 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
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|---|---|---|---|---|
| 1831745728 | Affinity Patient Coordination LLC | Case Manager/Care Coordinator | 217 E Monroe St Ste 204, Springfield, IL 62701-1746 | 2019-08-15 |
| 1578075107 | Christopher Worthen | Case Manager/Care Coordinator | 223 N Western Ave, Springfield, OH 45504-2719 | 2017-11-06 |
| 1497204622 | Inesha Simmons | Case Manager/Care Coordinator | 1331 Denison Dr, Apt C, Springfield, IL 62704-4454 | 2016-09-29 |
| 1235687138 | Yvonne Persley | Case Manager/Care Coordinator | 8 Allison Ct, Springfield, IL 62703-1130 | 2016-09-20 |
| 1902255516 | Dionna Marino | Case Manager/Care Coordinator | 731 Cheatham Street, Springfield, TN 37172 | 2016-06-06 |
| 1972918423 | Loree Lynn Howard | Case Manager/Care Coordinator | 4145 Jasper Road, Springfield, OR 97478 | 2014-06-24 |
| 1871907824 | Latisha Robinson | Case Manager/Care Coordinator | 3050 S National Ave Ste 104, Springfield, MO 65804-4242 | 2014-06-18 |
| 1548601792 | Richard S Buford | Case Manager/Care Coordinator | 1086 Mound St, Springfield, OH 45505-1191 | 2013-07-16 |
| 1164765228 | Colleen K Webb | Case Manager/Care Coordinator | 285 Third St. Extension, Springfield, GA 31329-1612 | 2013-03-27 |
| 1447503636 | Lifetime Support Incorporated | Case Manager/Care Coordinator | 52 Fadem Rd, Springfield, NJ 07081-3116 | 2012-10-25 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 01103 |
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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.