Shelli Pollard, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149018509 Issued in IL

Practice address

1818 Logan Ave
Belvidere, IL 61008-6412

Phone

(815) 575-9887

Fax

(815) 534-1437

NPI assigned

Dec 14, 2015

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

Enrolled in IL

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Revive Therapy and Wellness LLC

  • Clinical Social Worker
  • Belvidere, IL
  • NPI 1780446476
  Medicare reassignment NPD Authorized official
• Osf Lifeline Ambulance, LLC

  • Land Ambulance
  • Rockford, IL
  • NPI 1619036829
  NPD (past)
• Transformation Behavioral Health Associates LLC

  • Clinical Psychologist
  • Woodstock, IL
  • NPI 1710225644
  NPD (past)
• Transformation Behavioral Health PLLC

  • Clinical Social Worker
  • Woodstock, IL
  • NPI 1659066066
  NPD (past)

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1053786269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 LOGAN AVE",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610086412",
            "telephone_number": "815-575-9887",
            "fax_number": "815-534-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 LOGAN AVE",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610086412",
            "telephone_number": "815-575-9887",
            "fax_number": "815-534-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLARD",
        "first_name": "SHELLI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-14",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Perez
• James W Phoenix, MD
• Cassie M Piske, LMT RYT
• Jessica Piske, LCSW
• David G Pocock, M.D.
• Roger Allen Pope, DC
• Derek Michael Prado, D.C.
• Preston Scott Medical Group
• Noel Daniette Kupczyk Priest, ATC
• Prism Pharmacy Belvidere LTD

• Clinical Social Worker in Belvidere, IL
• Providers in Belvidere, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.