Shelby Vanbibber, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34010486A Issued in IN

Practice address

201 E Rudisill Blvd Ste B100
Fort Wayne, IN 46806-1738

Phone

(260) 255-3665

Fax

(260) 255-3594

NPI assigned

Oct 9, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Great Heights ABA Inc.

  • Behavior Analyst
  • Fort Wayne, IN
  • NPI 1336651736

  Clinical

  NPD

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1689455479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E RUDISILL BLVD STE B100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468061738",
            "telephone_number": "260-255-3665",
            "fax_number": "260-255-3594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E RUDISILL BLVD STE B100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468061738",
            "telephone_number": "260-255-3665",
            "fax_number": "260-255-3594"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Mercer Ave Ste Wfc",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IN",
            "postal_code": "467332303",
            "country_code": "US",
            "telephone_number": "260-255-3665",
            "fax_number": "260-255-3594",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1061 Smaltz Way",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "IN",
            "postal_code": "467069599",
            "country_code": "US",
            "telephone_number": "260-255-3665",
            "fax_number": "260-255-3594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANBIBBER",
        "first_name": "SHELBY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34010486A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylee Van Veld, BCBA
• Briana Van
• Van's Consulting Services, P.C.
• Tina Marie Vanallen
• Tamara L Vanbaalen, LCSW
• Jessica Vancamp
• Sandra Kay Vance
• Nancy Vancleave
• Lynn Vandame, PAC
• Megan Vandell, PMHNP

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2023; 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.