Active NPI
Theresa Shelley, LCSW
- Clinical Social Worker
- Butte, MT
National Provider Identifier
1659626083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2231
- Practice address
- 55 Basin Creek Rd
Butte, MT 59701-9704 - Phone
- (406) 496-6314
- Fax
- (406) 494-1724
- NPI assigned
- Jul 23, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2231 | MT | Primary |
Addresses
Primary practice location
55 Basin Creek Rd
Butte, MT 59701-9704
Mailing address
2025 Mullan Rd Apt 105
Missoula, MT 59808-2110
Phone (406) 745-3811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477745370 | Medicaid | MT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2231 | MT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343001600000",
"number": "1659626083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2025 MULLAN RD APT 105",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598082110",
"telephone_number": "406-745-3811",
"fax_number": "406-745-4070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 BASIN CREEK RD",
"city": "BUTTE",
"state": "MT",
"postal_code": "597019704",
"telephone_number": "406-496-6314",
"fax_number": "406-494-1724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELLEY",
"first_name": "THERESA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-23",
"last_updated": "2012-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MT",
"license": "2231",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1477745370",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Butte, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.