Individual provider Active NPI

Lisa Luanne Shelor-Flores, MSW ACSW LCSW

  • Clinical Social Worker
  • Greensboro, NC
National Provider Identifier
1558325233
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C000288 Issued in NC
Practice address
4443 Jessup Grove Rd
Greensboro, NC 27410-9934
Phone
(336) 547-1574
Fax
(336) 323-5247
NPI assigned
Apr 12, 2006
Last updated
Jan 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C000288 NC Primary

Addresses

Primary practice location

4443 Jessup Grove Rd
Greensboro, NC 27410-9934

Mailing address

4443 Jessup Grove Rd
Greensboro, NC 27410-9934
Phone (336) 547-1574

Other identifiers 3

IdentifierTypeStateIssuer
7565KOtherBCBS
137103000OtherMAGELLAN
6237765OtherUBH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C000288NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1558325233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4443 JESSUP GROVE RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274109934",
            "telephone_number": "336-547-1574",
            "fax_number": "336-323-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4443 JESSUP GROVE RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274109934",
            "telephone_number": "336-547-1574",
            "fax_number": "336-323-5247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELOR-FLORES",
        "first_name": "LISA",
        "middle_name": "LUANNE",
        "name_prefix": "Mrs.",
        "credential": "MSW ACSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C000288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "7565K",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "137103000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "6237765",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.