Shirley L Story-Nelson, LCSW, LMFT, LCAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34001161A Issued in IN

Practice address

4956 Washington St
Gary, IN 46408-4609

Phone

(219) 895-4830

NPI assigned

Sep 24, 2020

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

Other names 1

• Shirley L Carneygee Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1710594783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4956 WASHINGTON ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464084609",
            "telephone_number": "219-895-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4956 WASHINGTON ST",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464084609",
            "telephone_number": "219-895-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORY-NELSON",
        "first_name": "SHIRLEY",
        "middle_name": "L",
        "credential": "LCSW, LMFT, LCAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34001161A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRLEY",
            "last_name": "CARNEYGEE",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sterling Emergency Services of Indiana, Inc
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• Stephanie Stingley
• Timothy Stoehr
• Stacy Francine Stringer, SOICAL WORKER
• Beverly Darlene Strong
• Mark James Strudas, PT, DPT
• Ana Stubbs, MD
• Merievelyn Stuber, MS, RD, CD, CNSD

• Clinical Social Worker in Gary, IN
• Providers in Gary, 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 Sep 24, 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.