Shelley Eileen Beckley, LCSW
Individual provider Active NPI Social Worker · Macon, MO
NPI 1871048876 · NPPES record last updated Feb 19, 2019
Key facts
- NPI
- 1871048876
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 2019003938 (MO)
- Practice address
- 309 N Missouri St
Macon, MO 63552-2143 - Phone
- (660) 395-9114
- NPI assigned
- Aug 19, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mark Twain Association for Mental Health Inc
Practice addresses (Care Compare)
154 Forrest Dr
Hannibal, MO 63401-5511
Phone (573) 221-2120
309 N Missouri St
Macon, MO 63552-2143
Phone (660) 395-9114
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240416001005 | MO | Practitioner - Clinical Social Worker | 9739528332 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark Twain Association for Mental Health, Inc. | Multi-Specialty | Current |
Accepting new patients |
| Talkspace Provider Network PA | Multi-Specialty | Current |
Accepting new patients |
| Mark Twain Association for Mental Health, Inc | Current |
Accepting new patients |
Locations
154 Forrest Dr
Hannibal, MO 63401
Phone (573) 221-2120
309 N Missouri St
Macon, MO 63552
Phone (660) 395-9114
2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker |
104100000X | 2019003938 | MO | Yes |
Addresses
Primary practice location
309 N Missouri St
Macon, MO 63552-2143
Mailing address
1847 Highway K
Clarence, MO 63437-3015
Phone (660) 651-4120
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871048876 | Medicaid | MO |
Other providers in Macon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.