Active NPI
Shelby Legan
- Clinical Social Worker
- Warsaw, IN
National Provider Identifier
1326680174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 34008618A
- Practice address
- 105 Enterprise Dr
Warsaw, IN 46580-1204 - Phone
- (574) 268-0448
- NPI assigned
- Oct 14, 2019
- Last updated
- Dec 19, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 34008618A | IN | Primary |
Addresses
Primary practice location
105 Enterprise Dr
Warsaw, IN 46580-1204
Mailing address
1951 E Wade Rd
Warsaw, IN 46580-7696
Phone (574) 835-5448
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34008618A | IN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifeworks Counseling & Consulting, Inc. | Current | Accepting new patients |
Locations
105 Enterprise Dr
Warsaw, IN 46580
Phone 5742680448 ext. 308
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Professional Counselor
- Fort Wayne, IN
- NPI 1184886541
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576713600000",
"number": "1326680174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1951 E WADE RD",
"city": "WARSAW",
"state": "IN",
"postal_code": "465807696",
"telephone_number": "574-835-5448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 ENTERPRISE DR",
"city": "WARSAW",
"state": "IN",
"postal_code": "465801204",
"telephone_number": "574-268-0448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEGAN",
"first_name": "SHELBY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-14",
"last_updated": "2019-12-19",
"certification_date": "2019-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IN",
"license": "34008618A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warsaw, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.