Kathleen Shelley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05864800 Issued in NJ

Practice address

22 Robertson Rd
West Orange, NJ 07052-3519

Phone

(973) 809-6574

NPI assigned

Oct 8, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1023659331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 ROBERTSON RD",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070523519",
            "telephone_number": "973-809-6574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 ROBERTSON RD",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070523519",
            "telephone_number": "973-809-6574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLEY",
        "first_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05864800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marion D Shapiro, D.O.
• Kaitlin Shaw
• Tenesha Shaw
• Mary T Shea, OTR
• Abbas A. Shehadeh, MD
• Laura A Sheppard, LCSW
• Alisha Sheridan, OT
• Sarah Virginia Sheridan, SLP
• Anna Shingelo
• Bijan Shirazi, RPH

• Clinical Social Worker in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.