Shelley L. Anderson, PH.D., LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

PR-024864 Issued in NY

Practice address

140 Riverside Dr Ste 1-O
New York, NY 10024-2605

Phone

(212) 249-1302

Fax

(212) 988-4706

NPI assigned

Dec 6, 2017

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1992210405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E HARTSDALE AVE APT 3F",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105303528",
            "telephone_number": "914-723-5899",
            "fax_number": "212-988-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 RIVERSIDE DR STE 1-O",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100242605",
            "telephone_number": "212-249-1302",
            "fax_number": "212-988-4706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 E Hartsdale Ave Apt 3F",
            "address_purpose": "LOCATION",
            "city": "Hartsdale",
            "state": "NY",
            "postal_code": "105303528",
            "country_code": "US",
            "telephone_number": "914-723-5899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SHELLEY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR-024864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard C.E. Anderson, M.D.
• Rita Anderson, NP
• Rusian Eloise Anderson, FNP FAMILY NURSE PRA
• Sarah Ann Rachel Anderson, M.D., PH.D
• Shaquel Anderson
• Stacy Lee Anderson, MD
• Stewart A Anderson, M.D.
• Teri L Anderson, C.R.N.A.
• Thomas William Anderson III, DPT
• Toby Anderson, LCSW

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.