Mark D Shelton, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

111762 Issued in MA

Practice address

26 Queen St
Social Services
Worcester, MA 01610-2473

Phone

(508) 860-7700

Fax

(508) 860-7990

NPI assigned

Aug 9, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CA

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

Practice roles

Interoperability endpoints

• Direct secure messaging: mark.shelton@edchc.eclinicaldirectplus.com

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.

• M & K Shelton, Licensed Clinical Social Worker, Inc

  • Community/Behavioral Health Agency
  • El Dorado Hills, CA
  • NPI 1770176141
  NPD Authorized official

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1215947528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 QUEEN ST",
            "address_2": "SOCIAL SERVICES",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102473",
            "telephone_number": "508-860-7700",
            "fax_number": "508-860-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 QUEEN ST",
            "address_2": "SOCIAL SERVICES",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102473",
            "telephone_number": "508-860-7700",
            "fax_number": "508-860-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MA",
            "license": "111762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "99622101",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0300010",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP",
            "identifier": "1001250",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1300709",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert G Sheiman, M.D.
• Mollie Sheinman Krentzman
• Saraswathy Shekar, MD
• Tammy Marie Sheldon
• Karen Courtney Shellenbarger, NP
• Yvonne Shelton, M.D.
• Nida Shemmeri, MD
• Xue Yu Shen, DMD
• Xunuo Shen, M.D.
• Magdolin Shenouda

• Social Worker in Worcester, MA
• Providers in Worcester, MA by specialty
• Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.