Heather R Shelley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34003755A Issued in IN

Practice address

330 Lakeview Dr
Goshen, IN 46528-9365

Phone

(574) 533-1234

Fax

(574) 537-2652

NPI assigned

Jun 27, 2006

Sex

Female

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 1

Other names 1

• Heather R Severns Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Oaklawn Psychiatric Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Elkhart, IN
  • NPI 1598847212
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188432000000",
    "number": "1336176155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 LAKEVIEW DR",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465289365",
            "telephone_number": "574-533-1234",
            "fax_number": "574-537-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 LAKEVIEW DR",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465289365",
            "telephone_number": "574-533-1234",
            "fax_number": "574-537-2652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLEY",
        "first_name": "HEATHER",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003755A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000232532",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "SEVERNS",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathryn Marie Shantz, CNM
• Elise Sharkey, PA-C
• Melanie Shaw, APN
• Colleen A Shay, NP
• Kimberly Sheeley
• Michelle D Shelly, MD
• Anne Lehman Shenk, M.D.
• Vera May Shenk
• Shetler Psychological Services PC
• Jay R Shetler, PSYD, HSPP

• Clinical Social Worker in Goshen, IN
• Providers in Goshen, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.