Shelly Lynne Byndom, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2018030157 Issued in MO

Practice address

9666 Olive Blvd Ste 330
Olivette, MO 63132-3035

Phone

(314) 991-0100

NPI assigned

Nov 5, 2008

Last updated

Sep 18, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sojourn Therapy Outreach LLC

  • Clinical Social Worker
  • Saint Louis, MO
  • NPI 1679121529
  Authorized official Same address or phone

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1841444775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8331 WASHINGTON ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631146237",
            "telephone_number": "314-399-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9666 OLIVE BLVD STE 330",
            "city": "OLIVETTE",
            "state": "MO",
            "postal_code": "631323035",
            "telephone_number": "314-991-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Northgate Industrial Dr",
            "address_purpose": "LOCATION",
            "city": "Granite City",
            "state": "IL",
            "postal_code": "620406805",
            "country_code": "US",
            "telephone_number": "618-877-4420 x3035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BYNDOM",
        "first_name": "SHELLY",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-05",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.008052",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2018030157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Robert Brown, D.C.
• Adrianne Renee Bruckner
• Alexandria Bryant
• Elma Bumbulovic, RBT
• Hailey Burke, RBT
• Byron Duvall D.D.S. Gateway, P.C.
• Care Giver Supply Inc.
• Amy Pedigo Carmichael, PHD, MED, MA, LMFT
• Sherine S Chambers, PLPC
• David Chernof, MSW, LCSW

• Clinical Social Worker in Olivette, MO
• Providers in Olivette, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; 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.