Shelley Joan Clancy, RN, BSN, IBCLC,RLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

108-72946 Issued in NJ

Practice address

105 Roseland Ave
Unit 901
Caldwell, NJ 07006-5943

Phone

(201) 739-4058

NPI assigned

Oct 26, 2012

Last updated

Oct 26, 2012By 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 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1351209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351209600000",
    "number": "1417200502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 ROSELAND AVE",
            "address_2": "UNIT 901",
            "city": "CALDWELL",
            "state": "NJ",
            "postal_code": "070065943",
            "telephone_number": "201-739-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ROSELAND AVE",
            "address_2": "UNIT 901",
            "city": "CALDWELL",
            "state": "NJ",
            "postal_code": "070065943",
            "telephone_number": "201-739-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANCY",
        "first_name": "SHELLEY",
        "middle_name": "JOAN",
        "name_prefix": "Ms.",
        "credential": "RN, BSN, IBCLC,RLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-26",
        "last_updated": "2012-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NJ",
            "license": "108-72946",
            "primary": true
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NY",
            "license": "541810-1",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NJ",
            "license": "26NR06350900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12455215",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Steve Vincent Colacurcio Jr., D.C.

• Lactation Consultant (Registered Nurse) in Caldwell, NJ
• Providers in Caldwell, NJ by specialty
• Lactation Consultant (Registered Nurse) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; 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.