Individual provider Active NPI

Shellye Lerene Sledge, LCSW

  • Clinical Social Worker
  • Chesapeake, VA
National Provider Identifier
1912436239
Registry record updated Jun 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW27622 Issued in CA
Practice address
1434 Crossways Blvd
Chesapeake, VA 23320-3360
Phone
(619) 846-8498
Fax
(619) 846-8498
NPI assigned
Jun 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW27622 CA Primary

Addresses

Primary practice location

1434 Crossways Blvd
Chesapeake, VA 23320-3360

Mailing address

400 S Military Hwy Apt 2203
Virginia Beach, VA 23464-1892

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW27622CAMDClinical Social Worker
27622CAMDCritical Care Registered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496966400000",
    "number": "1912436239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S MILITARY HWY APT 2203",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234641892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 CROSSWAYS BLVD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203360",
            "telephone_number": "619-846-8498",
            "fax_number": "619-846-8498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLEDGE",
        "first_name": "SHELLYE",
        "middle_name": "LERENE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2017-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW27622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2017; 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.