Individual provider Active NPI

Shelbie Wells, CSW, TCADC

  • Clinical Social Worker
  • Bowling Green, KY
National Provider Identifier
1265809917
Registry record updated Jul 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
254243 Issued in KY
Practice address
380 Suwannee Trail St
Bowling Green, KY 42103-7956
Phone
(270) 901-5000
Fax
(270) 842-5268
NPI assigned
Aug 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 165322 KY
Clinical Social Worker 1041C0700X 252401 KY
Clinical Social Worker 1041C0700X 254243 KY Primary

Addresses

Primary practice location

380 Suwannee Trail St
Bowling Green, KY 42103-7956

Mailing address

380 Suwannee Trail St
Bowling Green, KY 42103-7956
Phone (270) 901-5000

Other names 1

  • Shelbie Lyon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20190808004220 KY Practitioner - Clinical Social Worker 6305173618 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
165322KYMDAddiction (Substance Use Disorder) Counselor
252401KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeskills, Inc. CurrentSince Jun 27, 2019 Accepting new patients

Locations

8324 Eagle Way
Chicago, IL 60678

428 Center St
Bowling Green, KY 42101

822 Woodway St
Bowling Green, KY 42101

330 E 10th Ave
Bowling Green, KY 42101

380 Suwannee Trail St
Bowling Green, KY 42103

501 Chestnut St
Bowling Green, KY 42101
Phone (270) 901-5712

205 Mohawk St
Brownsville, KY 42210
Phone (270) 597-2713

112 Sartin Dr
Edmonton, KY 42129
Phone (270) 432-2266

1031 Brookhaven Rd
Franklin, KY 42134
Phone (270) 586-8281

608 Happy Valley Rd
Glasgow, KY 42141
Phone (270) 651-8379

222 Industrial Dr N
Morgantown, KY 42261
Phone (270) 526-3877

118 W Union St
Munfordville, KY 42765
Phone (270) 524-2713

433 Shelton Ln
Russellville, KY 42276

512 Veterans Memorial Hwy
Scottsville, KY 42164
Phone (270) 237-4481

Organizations & group practices 1

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": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1265809917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 SUWANNEE TRAIL ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037956",
            "telephone_number": "270-901-5000",
            "fax_number": "270-842-5268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 SUWANNEE TRAIL ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037956",
            "telephone_number": "270-901-5000",
            "fax_number": "270-842-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "SHELBIE",
        "credential": "CSW, TCADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-28",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "165322",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "252401",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "254243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBIE",
            "last_name": "LYON",
            "credential": "CSW, TCADC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.