Provider Demographics
NPI:1063828812
Name:SHELL, ABBEY (LISW)
Entity Type:Individual
Prefix:
First Name:ABBEY
Middle Name:
Last Name:SHELL
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 NW WAGNER RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-4246
Mailing Address - Country:US
Mailing Address - Phone:515-423-0019
Mailing Address - Fax:
Practice Address - Street 1:614 NW WAGNER RIDGE CT
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4246
Practice Address - Country:US
Practice Address - Phone:515-423-0019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0726201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical