Provider Demographics
NPI:1689323875
Name:MESSENGER, SHELLY MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:MARIE
Last Name:MESSENGER
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 1:13280 EGGLESTON LN
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-8958
Mailing Address - Country:US
Mailing Address - Phone:714-875-3509
Mailing Address - Fax:
Practice Address - Street 1:13280 EGGLESTON LN
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-8958
Practice Address - Country:US
Practice Address - Phone:714-875-3509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA285421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical