Shellene M Hattersley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW20659 Issued in FL

Practice address

5392 N Persimmon Dr
Beverly Hills, FL 34465-2445

Phone

(904) 568-1417

NPI assigned

Nov 15, 2022

Last updated

Nov 15, 2022By the provider in NPPES

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 FL

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

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1285343533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5392 N PERSIMMON DR",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344652445",
            "telephone_number": "904-568-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5392 N PERSIMMON DR",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344652445",
            "telephone_number": "904-568-1417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "206 S Apopka Ave",
            "address_purpose": "LOCATION",
            "city": "Inverness",
            "state": "FL",
            "postal_code": "344524803",
            "country_code": "US",
            "telephone_number": "352-341-4160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATTERSLEY",
        "first_name": "SHELLENE",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW20659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn Jo Green, P.T.
• Kimberly Griffin, LMT
• Jason M Haas
• Jerome L Hansen, PA
• Lauren Hartwell
• Healing Crossroads Corporation
• Michael R Hedden, LMHC
• Atif H Henen, RPH
• Danette Herrera, L.P.T.A
• Reese Hewett

• Clinical Social Worker in Beverly Hills, FL
• Providers in Beverly Hills, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.