Provider Demographics
NPI:1013032093
Name:STEIN, SHELLEY (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:SHELLEY
Middle Name:
Last Name:STEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 W WINDWARD WAY
Mailing Address - Street 2:APT 204
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462
Mailing Address - Country:US
Mailing Address - Phone:561-540-3666
Mailing Address - Fax:
Practice Address - Street 1:802 W WINDWARD WAY
Practice Address - Street 2:APT 204
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462
Practice Address - Country:US
Practice Address - Phone:561-789-3447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW56281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical