Provider Demographics
NPI:1497437263
Name:SHELTON, MICHELLE (LSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:SHELTON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7783 E RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-2458
Mailing Address - Country:US
Mailing Address - Phone:219-769-4005
Mailing Address - Fax:219-945-3673
Practice Address - Street 1:7783 E RIDGE RD
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-2458
Practice Address - Country:US
Practice Address - Phone:219-769-4005
Practice Address - Fax:219-945-3673
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker