Provider Demographics
NPI:1215445945
Name:SHELTON, ANDREW WILLIAM (LCSW)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:WILLIAM
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 514
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-0514
Mailing Address - Country:US
Mailing Address - Phone:312-680-4097
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 514
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-0514
Practice Address - Country:US
Practice Address - Phone:312-680-4097
Practice Address - Fax:773-409-8576
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-16
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.101899104100000X
IL149.0206841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker