Healthcare Provider Details

I. General information

NPI: 1740613223
Provider Name (Legal Business Name): SALILA SHEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 12/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 PASSMORE DR
WILMINGTON DE
19803-1548
US

IV. Provider business mailing address

2307 WOODLAND LN
WILMINGTON DE
19810-4054
US

V. Phone/Fax

Practice location:
  • Phone: 302-478-9411
  • Fax:
Mailing address:
  • Phone: 302-388-5112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW017393
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0001230
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: