Individual provider Active NPI

Diona Ranee Shelton, LCSW

  • Clinical Social Worker
  • Troy, IL
National Provider Identifier
1194206607
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.019778 Issued in IL
Practice address
189 E US Highway 40 Ste D
Troy, IL 62294-2267
Phone
(618) 744-0844
Fax
(618) 505-5044
NPI assigned
Aug 22, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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 149.019778 IL Primary

Addresses

Primary practice location

189 E US Highway 40 Ste D
Troy, IL 62294-2267

Mailing address

8 Carolyn St
Glen Carbon, IL 62034-1940
Phone (618) 744-0844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, IL, MO3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20231018002641 TX Practitioner - Clinical Social Worker 4789039231 Reassigns benefits to 1 organization
I20240122001671 IL Practitioner - Clinical Social Worker 4789039231 Reassigns benefits to 1 organization
I20260624001631 MO Practitioner - Clinical Social Worker 4789039231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Medical PAGroup PAC ID 3678948809, 92 clinicians

Practice addresses (Care Compare)

1440 W Taylor St
Chicago, IL 60607-4623
Phone (415) 360-3348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.019778ILMDClinical Social Worker
111248TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.C. CurrentSince Jan 2, 2024 Accepting new patients
Brightside Medical, P.a. CurrentSince Jan 2, 2024 Accepting new patients
New Beginnings Counseling Services, LLC Current Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

1440 W Taylor St
Chicago, IL 60607
Phone (612) 263-9334

189 E US Highway 40
Ste D
Troy, IL 62294
Phone (618) 744-0844

3571 Far West Blvd
Austin, TX 78731
Phone (512) 567-4737

Organizations & group practices 4

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": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1194206607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CAROLYN ST",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341940",
            "telephone_number": "618-744-0844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 E US HIGHWAY 40 STE D",
            "city": "TROY",
            "state": "IL",
            "postal_code": "622942267",
            "telephone_number": "618-744-0844",
            "fax_number": "618-505-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "DIONA",
        "middle_name": "RANEE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, IL

Sources for this page

Verify at the official NPI Registry.