Shalonda Dallett Carlisle, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C5788 Issued in MS

Practice address

3975 I 55 N Apt T3
Jackson, MS 39216-3726

Phone

(601) 383-1076

NPI assigned

Apr 23, 2013

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 MS

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1124462965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 I 55 N APT T3",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392163726",
            "telephone_number": "601-383-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 I 55 N APT T3",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392163726",
            "telephone_number": "601-383-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "SHALONDA",
        "middle_name": "DALLETT",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-23",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C5788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caring Hands Community Services Inc
• Caring Interventions
• Ciaran Carlile
• Alexander Carlisle, MD
• Carrie A. Carlisle, RNFA
• Christopher Haley Carlton, D.M.D.
• Frederick Barnett Carlton Jr., M.D.
• Miller Carlton
• Scott A Carlton, MD
• Alexander Hall Carlyle

• Clinical Social Worker in Jackson, MS
• Providers in Jackson, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.