Shelly Marie Luttman Phelps, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C008789 Issued in NC

Practice address

360 N Caswell Rd
Charlotte, NC 28204

Phone

(917) 583-5508

NPI assigned

Mar 16, 2015

Last updated

Aug 21, 2018By 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 NC

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

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Best Life Counseling, PLLC

  • Mental Health Counselor
  • Huntersville, NC
  • NPI 1528532975
  Medicare reassignment NPD
• Serendipity Therapy, PLLC

  • Clinical Social Worker
  • Belmont, NC
  • NPI 1538493770
  Medicare reassignment NPD

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1447643325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12107 MONTEITH GROVE DR",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280784257",
            "telephone_number": "917-583-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 N CASWELL RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "917-583-5508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "363 Williamson Rd",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281175973",
            "country_code": "US",
            "telephone_number": "917-583-5508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14636 Reese Blvd W Ste B3",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787956",
            "country_code": "US",
            "telephone_number": "917-583-5508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "SHELLY",
        "middle_name": "MARIE LUTTMAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dermot Michael Phelan, MD
• Phelps DMD & Associates
• Jaryn Royce Phelps, AUD
• Kevin Daniel Phelps, MD
• Khadijah Lynn Phelps
• Phenogen Sciences Inc.
• Varsha Laxman Pherwani, MD
• Debra Phifer-Smith
• Britney Mobley Phifer, LMFT
• Charles Maurice Phifer

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.