Provider Demographics
NPI:1295841559
Name:SHELTON, RONALD L (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:L
Last Name:SHELTON
Suffix:
Gender:M
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:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1430
Mailing Address - Country:US
Mailing Address - Phone:540-437-7989
Mailing Address - Fax:540-437-7984
Practice Address - Street 1:644 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3750
Practice Address - Country:US
Practice Address - Phone:540-564-5960
Practice Address - Fax:540-433-4338
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040030581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008913374Medicaid
VA2024819OtherCIGNA PROVIDER NUMBER
VA370017OtherTRICARE
VA087259OtherSENTARA PROVIDER NUMBER
VA1164637518OtherGROUP NPI NUMBER
VAC05754OtherMEDICARE GROUP NUMBER
VA11527373OtherCAQH
VA158359OtherVALUE OPTIONS PROVIDER NO
VA437780OtherANTHEM PROVIDER NUMBER
VA188099OtherCOMPSYCH PROVIDER NUMBER
VA1164637518OtherGROUP NPI NUMBER
VA2024819OtherCIGNA PROVIDER NUMBER