Provider Demographics
NPI:1912152216
Name:SHELLABY, JACQUELINE ANN (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:JACQUELINE
Middle Name:ANN
Last Name:SHELLABY
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 1:12806 FRANKSTOWN RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PENN HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15235-1947
Mailing Address - Country:US
Mailing Address - Phone:412-335-8781
Mailing Address - Fax:
Practice Address - Street 1:12806 FRANKSTOWN RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PENN HILLS
Practice Address - State:PA
Practice Address - Zip Code:15235-1947
Practice Address - Country:US
Practice Address - Phone:412-335-8781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0167001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical