Individual provider Active NPI

Shellie Massey, LCSW

  • Clinical Social Worker
  • Covington, KY
National Provider Identifier
1649906595
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
257073 Issued in KY
Practice address
513 Madison Ave
Covington, KY 41011-1505
Phone
(859) 578-3200
NPI assigned
Jul 25, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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 257073 KY Primary

Addresses

Primary practice location

513 Madison Ave
Covington, KY 41011-1505

Mailing address

503 Farrell Dr
Covington, KY 41011-3775
Phone (859) 578-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20220812002682 KY Practitioner - Clinical Social Worker 6507249224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

513 Madison Ave
FL 4
Covington, KY 41011-1562
Phone (859) 578-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
257073KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Kentucky Mental Health Mental Retardation Regional Board CurrentSince Jul 15, 2022 Accepting new patients
Northern Kentucky Mental Health Mental Retardation Regional Board CurrentSince Jul 15, 2022 Accepting new patients

Locations

513 Madison Ave
Covington, KY 41011
Phone (859) 291-1121

513 Madison Ave
Fl 4
Covington, KY 41011

503 Farrell Dr
Covington, KY 41011
Phone (606) 578-3214

7459 Burlington Pike
Florence, KY 41042
Phone (859) 282-6585

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1649906595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 FARRELL DR",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410113775",
            "telephone_number": "859-578-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 MADISON AVE",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410111505",
            "telephone_number": "859-578-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSEY",
        "first_name": "SHELLIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "257073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, KY

Sources for this page

Verify at the official NPI Registry.