Shelley Renee Plude, L.I.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16633 Issued in MN

Practice address

324 W Superior St
Ste 600
Duluth, MN 55802-1701

Phone

(218) 723-8153

Fax

(218) 722-7625

NPI assigned

Jul 15, 2010

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

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Arrowhead Psychological Clinic, P.a.Group PAC ID 4880629633, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Arrowhead Psychological Clinic, P.a.

  • Clinical Psychologist
  • Duluth, MN
  • NPI 1619032562
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1922311208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST",
            "address_2": "STE 600",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021701",
            "telephone_number": "218-723-8153",
            "fax_number": "218-722-7625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST",
            "address_2": "STE 600",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021701",
            "telephone_number": "218-723-8153",
            "fax_number": "218-722-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLUDE",
        "first_name": "SHELLEY",
        "middle_name": "RENEE",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Plastic Surgery Center of Duluth PLLC
• Dawn Barbara Plath, LICSW
• Todd Plocher, PA-C
• David Bryan Plude, PSYD, LP
• Diedre K Plude, MA, LP
• Walter E Plude, MSED, LP
• Nikki Plys
• Jessica Marie Podpeskar, LICSW
• Christopher Pogliano
• Richard Phillip Poirier

• Clinical Social Worker in Duluth, MN
• Providers in Duluth, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.

Verify at the official NPI Registry.