Kelly Shifflett, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904020267 Issued in VA

Practice address

9228 George Washington Memorial Hwy
Gloucester, VA 23061-4162

Phone

(804) 695-8120

Fax

(804) 695-8122

NPI assigned

Apr 9, 2026

Sex

Female

Sole proprietor

No

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 VA

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, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Middle Peninsula Northern Neck Mental Health & Retardation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gloucester, VA
  • NPI 1497717615

  VA

  Medicare reassignment
• Middle Peninsula-Northern Neck Mental Health and Mental Retardation

  • Speech-Language Pathologist
  • Urbanna, VA
  • NPI 1992879282
  NPD (past)

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

{
    "created_epoch": "1775692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1679415376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9228 GEORGE WASHINGTON MEMORIAL HWY",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614162",
            "telephone_number": "804-695-8120",
            "fax_number": "804-695-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 GEORGE WASHINGTON MEMORIAL HWY",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614162",
            "telephone_number": "804-695-8120",
            "fax_number": "804-695-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIFFLETT",
        "first_name": "KELLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-09",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904020267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sentara Medical Group
• Sentara Medical Group
• Tiina J Shackelford, COTA/L
• Virginia Sherrod, PHARMD
• Parthiv J Sheth, M.D.
• Shining Light Behavioral Health - Whittaker
• Amy A Shipley, M.D.
• Wendy S Shulman, N.P.
• Richard Thomas Sieller, PT
• Valarie Sikes-Nova, PSY.D.

• All providers in Gloucester, VA
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.