Individual provider Active NPI

Chasity Danielle Shelton, LMSW

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1053685594
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801093986 Issued in MI
Practice address
17421 Telegraph Rd
Detroit, MI 48219-3165
Phone
(313) 531-2500
NPI assigned
Mar 1, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801093986 MI Primary

Addresses

Primary practice location

17421 Telegraph Rd
Detroit, MI 48219-3165

Mailing address

17421 Telegraph Rd
Detroit, MI 48219-3165
Phone (313) 531-2500

Other identifiers 1

IdentifierTypeStateIssuer
1883825MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170914003010 MI Practitioner - Clinical Social Worker 8820362874 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801093986MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New Life Alternatives LLC CurrentSince Nov 1, 2021 Accepting new patients
Beyond the Surface Counseling & Consulting LLC Clinical CurrentSince Jan 30, 2023 Accepting new patients

Locations

3281 Coolidge Hwy
Berkley, MI 48072
Phone (313) 915-9138

41800 Hayes Rd
Ste 522C
Clinton Township, MI 48038
Phone (586) 277-8999

31235 Harper Ave
Ste 244
Saint Clair Shores, MI 48082
Phone (313) 334-8402

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053685594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17421 TELEGRAPH RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193165",
            "telephone_number": "313-531-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17421 TELEGRAPH RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193165",
            "telephone_number": "313-531-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "CHASITY",
        "middle_name": "DANIELLE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1883825",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.