Healthcare Provider Details

I. General information

NPI: 1831026715
Provider Name (Legal Business Name): SHELBY RANEE BEAUCHAMP LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 10TH ST STE 104
POCOMOKE CITY MD
21851-1607
US

IV. Provider business mailing address

PO BOX 1978
SALISBURY MD
21802-1978
US

V. Phone/Fax

Practice location:
  • Phone: 410-957-0273
  • Fax: 410-957-0152
Mailing address:
  • Phone: 410-749-1015
  • Fax: 410-749-0654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number34883
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: