Provider Demographics
NPI:1922147677
Name:SHELTON-TOWNES, JOSEPHINE (LISW,SAP)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:SHELTON-TOWNES
Suffix:
Gender:F
Credentials:LISW,SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23306 FERNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-1514
Mailing Address - Country:US
Mailing Address - Phone:216-831-2011
Mailing Address - Fax:216-831-2011
Practice Address - Street 1:20620 N PARK BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-4519
Practice Address - Country:US
Practice Address - Phone:216-374-7836
Practice Address - Fax:216-831-2011
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 00047531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical