Individual provider Active NPI

Courtney Shelton, LCSW

  • Clinical Social Worker
  • Prince Frederick, MD
National Provider Identifier
1063291300
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09928853 Issued in CO
Practice address
366 Medallion Dr
Prince Frederick, MD 20678-4467
Phone
(410) 474-4863
NPI assigned
Sep 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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 CSW.09928853 CO Primary

Addresses

Primary practice location

366 Medallion Dr
Prince Frederick, MD 20678-4467

Mailing address

366 Medallion Dr
Prince Frederick, MD 20678-4467
Phone (410) 474-4863

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20251210003976 VT Practitioner - Clinical Social Worker 4688168248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Centers of Burlington IncGroup PAC ID 2062491251, 84 clinicians

Practice addresses (Care Compare)

617 Riverside Ave
Burlington, VT 05401-1601
Phone (802) 864-6309

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09928853COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of Burlington Inc CurrentSince Oct 3, 2025 Accepting new patients
Community Health Centers of Burlington Inc CurrentSince Oct 3, 2025 Accepting new patients

Locations

789 Pine St
Burlington, VT 05401
Phone (802) 264-1052

617 Riverside Ave
Burlington, VT 05401
Phone (802) 264-8158

Interoperability endpoints

  • Direct secure messaging: courtney.shelton.p1@direct.chcb.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1063291300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 MEDALLION DR",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784467",
            "telephone_number": "410-474-4863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 MEDALLION DR",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784467",
            "telephone_number": "410-474-4863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "COURTNEY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09928853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

Verify at the official NPI Registry.