Provider Demographics
NPI:1750981510
Name:BIGELOW, SHELLIE (MSW)
Entity type:Individual
Prefix:
First Name:SHELLIE
Middle Name:
Last Name:BIGELOW
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 1:80 JESSE HILL JR DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3050
Mailing Address - Country:US
Mailing Address - Phone:404-616-6243
Mailing Address - Fax:404-616-9898
Practice Address - Street 1:341 PONCE DE LEON AVE NE STE 212
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2012
Practice Address - Country:US
Practice Address - Phone:404-616-6243
Practice Address - Fax:404-616-9898
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker