Individual provider Active NPI

Shelby Elizabeth Mitchell, LMSW, C-SWI

  • Social Worker
  • Las Vegas, NV
National Provider Identifier
1053147629
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
11748-M Issued in NV
Practice address
801 S Rancho Dr Ste E3A
Las Vegas, NV 89106-3812
Phone
(702) 620-9354
NPI assigned
Sep 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 11748-M NV Primary

Addresses

Primary practice location

801 S Rancho Dr Ste E3A
Las Vegas, NV 89106-3812

Mailing address

1960 Continental Ave
Las Vegas, NV 89156-6921
Phone (702) 325-3620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11748-MNVMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1053147629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 CONTINENTAL AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891566921",
            "telephone_number": "702-325-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S RANCHO DR STE E3A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891063812",
            "telephone_number": "702-620-9354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "SHELBY",
        "middle_name": "ELIZABETH",
        "credential": "LMSW, C-SWI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NV",
            "license": "11748-M",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.