MEDICARE: SHELBY TALBOT LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	113799	NY

General Provider Information

NPI Number	:	1134014558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELBY TALBOT LCSW

Provider Business Mailing Address
First Line	:	13 PEARL ST APT 7
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14607-3532
Country	:	US
Telephone Number	:	315-877-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2619 W HENRIETTA RD STE F
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-2327
Country	:	US
Telephone Number	:	585-944-3651
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2025
Last Update Date	:	06/22/2026

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