Active NPI
Jacqueline Ann Shellaby, LCSW
- Clinical Social Worker
- Penn Hills, PA
National Provider Identifier
1912152216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW016700
- Practice address
- 12806 Frankstown Rd
2ND Floor
Penn Hills, PA 15235-1947 - Phone
- (412) 335-8781
- NPI assigned
- Dec 1, 2008
- Last updated
- Apr 3, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW016700 | PA | Primary |
Addresses
Primary practice location
12806 Frankstown Rd
2ND Floor
Penn Hills, PA 15235-1947
Mailing address
12806 Frankstown Rd
2ND Floor
Penn Hills, PA 15235-1947
Phone (412) 335-8781
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130628000140 | PA | Practitioner - Clinical Social Worker | 8820238660 | Practice locations: Penn Hills, PA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
12806 Frankstown Rd
Penn Hills, PA 15235-1947
Phone (412) 335-8781
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CW016700 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491177600000",
"number": "1912152216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12806 FRANKSTOWN RD",
"address_2": "2ND FLOOR",
"city": "PENN HILLS",
"state": "PA",
"postal_code": "152351947",
"telephone_number": "412-335-8781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12806 FRANKSTOWN RD",
"address_2": "2ND FLOOR",
"city": "PENN HILLS",
"state": "PA",
"postal_code": "152351947",
"telephone_number": "412-335-8781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELLABY",
"first_name": "JACQUELINE",
"middle_name": "ANN",
"name_prefix": "Miss",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-01",
"last_updated": "2017-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW016700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Penn Hills, PA
- Jada Robinson
- Lea M Robinson
- Safe Haven Group Home LLC
- Shirley Ann Seals, M.S.
- Serenity Life Management Group
- Janet Elizabeth Horton Spink, MA, MT-BC, LPC
- Stability Home Care Services, LLC
- Dominique J Stevens-Young, MSW, LCSW
- Christopher Domenic Szelong, PHARMD
- Thrift Drug Inc (Rite Aid Pharmacy 10947)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; 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.