Provider Demographics
NPI:1376228890
Name:SHELL, CHLOE (MSW)
Entity Type:Individual
Prefix:MISS
First Name:CHLOE
Middle Name:
Last Name:SHELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 CAPLEWOOD DR APT 6
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-7904
Mailing Address - Country:US
Mailing Address - Phone:703-955-0473
Mailing Address - Fax:
Practice Address - Street 1:535 JACK WARNER PKWY NE STE G2
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5715
Practice Address - Country:US
Practice Address - Phone:703-955-0473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist