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NPI Code Detail

MEDICARE: TONI SHELLEY CHW

MEDICARE: TONI SHELLEY CHW
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
1172V00000XCommunity Health WorkerMI

General Provider Information

NPI Number : 1578420295
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONI SHELLEY CHW
Provider Business Mailing Address
First Line : 13901 E JEFFERSON AVE
Second Line :
City : DETROIT
State : MI
Zip : 48215-2720
Country : US
Telephone Number : 313-821-2591
Fax Number : 313-822-0950
Provider Business Practice Location Address
First Line : 7900 KERCHEVAL ST
Second Line :
City : DETROIT
State : MI
Zip : 48214-2439
Country : US
Telephone Number : 313-921-5500
Fax Number : 313-922-0824
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2026
Last Update Date : 01/06/2026

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Directions to “ TONI SHELLEY CHW” Practice Location

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