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RAVEN-JADE HARLEQUINN SHADDOWS
NPI 1336987684
Case Manager/Care Coordinator in Watertown, NY

Active since July 19, 2024
650 STATE ST, WATERTOWN, NY 13601(315) 755-1251 Get Directions Write a Review

NPPES record last updated: June 11, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Raven-jade Harlequinn Shaddows NPPES

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

RAVEN-JADE HARLEQUINN SHADDOWS (NPI 1336987684) is an individual case manager/care coordinator provider in Watertown, New York and active in the NPI registry since July 2024.

NPPES Registry Identity

NPI1336987684
Entity TypeIndividualMale
Primary Taxonomy171M00000X
Provider Legal NameRAVEN-JADE HARLEQUINN SHADDOWS
Location Address650 STATE STWatertown, NY 13601-2839
Mailing Address324 County Route 51 Bldg 1Malone, NY 12953-4502 · (518) 483-1251 · Fax (518) 483-2242
Phone(315) 755-1251
Sole ProprietorNo
Enumeration DateJuly 19, 2024
Last NPPES UpdateJune 11, 2026
NPPES CertifiedJune 11, 2026
✔ NPI 1336987684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCase Manager/Care CoordinatorOther Service Providers
Taxonomy Code171M00000X
Definition
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.
650 STATE ST, Watertown, NY 13601
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Other Providers at the Same Location NPPES 20

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

KENZIE AUGUSTUS SOCIAL WORKER
Social Worker
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251
MIRIAH KRISTINE QUESENBERRY
Registered Nurse
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251
ANGEL J SHEPHERD
Licensed Practical Nurse
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251
SABRINA KAY MADDEN RN
Registered Nurse
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251
YANILIS ARROYO CRUZ
Student in an Organized Health Care Education/Training Program
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251
NATALIE RIVELLLI MHC
Counselor (Mental Health)
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251
EMILY LANTRY
Peer Specialist
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251
ARIANNA ELISE BARKER I
Case Manager/Care Coordinator
650 STATE ST
WATERTOWN, NY 13601
Jefferson County (315) 755-1251

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raven-jade Shaddows's NPI number?

The NPI number for Raven-jade Shaddows is 1336987684. It was assigned to this individual provider in the NPPES registry on July 19, 2024.

Where is Raven-jade Shaddows located?

Raven-jade Shaddows practices at 650 State St, Watertown, NY 13601. The listed phone number is (315) 755-1251.

What is Raven-jade Shaddows's specialty?

The primary specialty registered for this NPI is Case Manager/Care Coordinator with taxonomy code 171M00000X.

When was this NPI record last updated?

The NPPES record for Raven-jade Shaddows was last updated on June 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 54 days 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.