SHAUNTAE WILLIS


Address: 901 Boren Ave, Suite1300, Seattle, WA 98104-3595
Phone: 2066190028

SHAUNTAE WILLIS (NPI# 1790938355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1790938355
Entity Type Individual
Full Name SHAUNTAE WILLIS
Credential LICSW, CDP
Practice Address 901 Boren Ave
Suite1300
Seattle
WA 98104-3595
Mailing Address 901 Boren Ave
Suite 1300
Seattle
WA 98104-3595
Practice Telephone 2066190028
Mailing Telephone 2066190028
Enumeration Date 2008-10-28
Last Update Date 2013-08-09
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
CP 00005642 WA Behavioral Health & Social Service Providers
Y 1041C0700X Social Worker
Specialization: Clinical
LW 60003495 WA Behavioral Health & Social Service Providers

Office Location

Street Address 901 BOREN AVE
SUITE1300
City SEATTLE
State WA
Zip Code 98104-3595

Providers in the same location

NPI Name Taxonomy Address Enumeration
1841288016 Wallace R Hodges Internal Medicine 901 Boren Ave, Ste 615, Seattle, WA 98104-3595 2005-10-11
1871082164 The Moore Center PC Clinic/Center 901 Boren Ave, Suite #1800, Seattle, WA 98104 2018-05-02
1295276251 Mjr Counseling and Consultation, P.l.l.c. Counselor 901 Boren Ave, Suite 1300, Seattle, WA 98104-3595 2017-03-10
1689111346 Lonnie Renteria Counselor 901 Boren Ave, Ste 1300, Seattle, WA 98104-3595 2017-01-19
1730621483 Arbor Hills Wellness Clinic/Center 901 Boren Ave, Suite 1300, Seattle, WA 98104-3595 2016-11-12
1760934939 Melanie Chitwood Counselor 901 Boren Ave, Suite 1300, Seattle, WA 98104-3595 2016-11-03
1699225888 Claritas Counseling and Evaluations, Plc Community/Behavioral Health 901 Boren Ave, Ste 1800, Seattle, WA 98104-3595 2016-10-11
1619422102 Aletheia Therapeutics, LLC Counselor 901 Boren Ave, Suite 701, Seattle, WA 98104-3595 2016-08-24
1477906907 Smile Art By Jaime Lee Dds Dentist 901 Boren Ave, Ste 1030, Seattle, WA 98104-3595 2016-07-20
1720447345 Christina Palumbo Physical Therapist 901 Boren Ave, Ste. 410, Seattle, WA 98104-3595 2016-02-11
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699394312 Richard Charles Harruff Pathology King County Medical Examiners Office, 325 Ninth Avenue, Seattle, WA 98104 2020-04-13
1558999474 Nathan Richard Benner Student in an Organized Health Care Education/Training Program Uw Medicine-harborview Medical Center Orthopaedics, 325 Ninth Avenue, Seattle, WA 98104 2020-03-27
1063058493 Brook, LLC. Health Educator 311 1/2 Occidental Ave South, Suite 210, Seattle, WA 98104 2019-11-20
1609418813 Stephanie Amanda Ann Mason Student in an Organized Health Care Education/Training Program 325 9th Avenue, Mail Stop #359796, Seattle, WA 98104 2019-10-09
1013480250 Robert Kenneth Lozier Pedorthist Norm Maleng Building, 410 9th Ave, 4th Floor, Seattle, WA 98104 2019-01-10
1548739576 Lee Hanses Physical Therapist 1124 Columbia Street, Level P1, Suite P100, Seattle, WA 98104 2018-11-20
1821579095 Karissa Lin Lee Pharmacist 401 Broadway #2075, Seattle, WA 98104 2018-08-27
1477042091 Maham Jehangir Student in an Organized Health Care Education/Training Program 325 9th Ave Department of Radiology, Seattle, WA 98104 2018-05-09
1740786581 Philip Daniel Tolley Student in an Organized Health Care Education/Training Program 325 9th Ave. Mail Stop#359796, 7th Floor Center Tower Rm #73.1, Seattle, WA 98104 2018-04-02
1528564242 Vanessa Dawn Leonhard Student in an Organized Health Care Education/Training Program 325 9th Ave, 7th Floor Center Tower Room 73.1, Mail Stop #359796, Seattle, WA 98104 2018-04-02
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Taxonomy Information

Taxonomy Code 1041C0700X
Grouping Behavioral Health & Social Service Providers
Classification Social Worker
Specialization Clinical

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063011609 Caroline A Lanza Social Worker 13035 39th Ave Ne, Seattle, WA 98125-4613 2020-10-24
1730787540 Regina Yeh Social Worker 5011b 44th Ave Ne, Seattle, WA 98105-2909 2020-10-14
1447864889 Noah Starer Social Worker 3719 S Angeline St Apt 2, Seattle, WA 98118-1761 2020-09-02
1073123733 Namkung Counseling Social Worker 2611 Ne 125th St Ste 116, Seattle, WA 98125-4374 2020-08-06
1912515503 Madeline Cody Ritter Social Worker 1818 E Madison St Apt 407, Seattle, WA 98122-3184 2020-07-20
1679191761 Sarah Louise Gossman Davis Social Worker 2100 Westlake Ave N Ste 201, Seattle, WA 98109-5802 2020-07-06
1184249021 Jennifer J Moyer-taylor Social Worker 13532 15th Pl Ne, Seattle, WA 98125-3202 2020-06-16
1528682440 Perinatal Support Washington Social Worker 2319 N 45th St Ste 303, Seattle, WA 98103-6979 2020-06-05
1063033678 Kate Brickell Social Worker 2524 16th Ave S # 305, Seattle, WA 98144-5104 2020-05-05
1710507439 Sara Miller Brown Social Worker 905 Dexter Ave N Apt L100, Seattle, WA 98109-3891 2020-04-22
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Competitor

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City SEATTLE
Zip Code 98104

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Dataset Information

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.

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