Olivia Lea Shuttleworth, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

DP00453081 Issued in WV

Practice address

1659 Hornbeck Rd
Morgantown, WV 26508-4757

Phone

(304) 629-1779

NPI assigned

Sep 5, 2006

Sex

Female

Sole proprietor

Yes

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)

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.

• Teresa L. White

  dba Pro Medical Rehab

  • Massage Therapist
  • Morgantown, WV
  • NPI 1467668368
  NPD (past)

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1487756821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1659 HORNBECK RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265084757",
            "telephone_number": "304-629-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1659 HORNBECK RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265084757",
            "telephone_number": "304-629-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTTLEWORTH",
        "first_name": "OLIVIA",
        "middle_name": "LEA",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW013709",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00453081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Shultz-Park
• Heidi Shultz
• Mariah Janelle Shultz, PA-C
• Linda I Shuster, CCC/SLP
• Morgan Shutler
• Laurel Shymansky, PA-C
• Georgia Siburt
• Raheel Sufian Siddiqui, MD
• Taha Siddiqui, MD
• Tiffany Siders

• Clinical Social Worker in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Clinical Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.