Shelly Warren, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

211687 Issued in MA

Practice address

38 Baldwin St
East Longmeadow, MA 01028-2201

Phone

(413) 237-6921

NPI assigned

Feb 20, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1356486351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 HOPKINS PL",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011061942",
            "telephone_number": "413-827-8959",
            "fax_number": "413-827-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 BALDWIN ST",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "010282201",
            "telephone_number": "413-237-6921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 E Columbus Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011052506",
            "country_code": "US",
            "telephone_number": "413-827-8959 x370",
            "fax_number": "413-827-7015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARREN",
        "first_name": "SHELLY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "211687",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Walker
• Jennifer Wallace-Johnson
• Kelly M Wallace
• Jennifer Gavrillen Walsh, D.M.D.
• Avery Grace Warner, PA-C
• June Watts, LPC
• Lynne M Weidl, PT
• Welcoming Safe Space Therapeutic Services, Inc.
• Priscilla Seibles Weldon, LMHC, LPC
• Wellness Within LLC

• Clinical Social Worker in East Longmeadow, MA
• Providers in East Longmeadow, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.