MRS. SHADORA DELAINE CROCKETT LMSW, LSW
NPI 1174008726
Social Worker - Clinical in Holland, OH

Q: What is Shadora Crockett's NPI number?

The NPI number for Shadora Crockett is 1174008726. It was assigned to this individual provider in the NPPES registry on September 29, 2018.

Q: What is Shadora Crockett's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Shadora Crockett was last updated on October 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 29, 2018

1905 PERRYSBURG HOLLAND RD, HOLLAND, OH 43528(419) 693-1520 Get Directions Write a Review

NPPES record last updated: October 11, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 11, 2024, Sep 29, 2018 (2 updates tracked since 2018).

On this page

About Mrs. Shadora Delaine Crockett Lmsw, Lsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. SHADORA DELAINE CROCKETT LMSW, LSW (NPI 1174008726) is an individual clinical provider in Holland, Ohio, licensed in Ohio (S.2106077) and active in the NPI registry since September 2018. She maintains a secondary practice location in Toledo.

NPPES Registry Identity

NPI1174008726

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMRS. SHADORA DELAINE CROCKETTCredential: LMSW, LSW

Location Address1905 PERRYSBURG HOLLAND RDHolland, OH 43528-9582

Mailing Address2005 Ashland AveToledo, OH 43620-1703 · (419) 841-7701

Phone(419) 693-1520

Sole ProprietorNo

Enumeration DateSeptember 29, 2018

Last NPPES UpdateOctober 11, 20242 updates tracked since enumeration

NPPES CertifiedOctober 11, 2024

✔ NPI 1174008726 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in OH · S.2106077

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1905 PERRYSBURG HOLLAND RD, Holland, OH 43528

Open in Google Maps ↗

Secondary Practice Location 1

Location 12005 Ashland AveToledo, OH 43620-1703 · Phone (419) 841-7701

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHNATHAN CURTIS NICHOLS

Case Manager/Care Coordinator