Healthcare Provider Details
I. General information
NPI: 1154188019
Provider Name (Legal Business Name): RACHEL ELIZABETH SHELTON LMSW, CSC-AD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/06/2024
Last Update Date: 01/10/2025
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
560 RIVERSIDE DR STE A204
SALISBURY MD
21801-4704
US
IV. Provider business mailing address
PO BOX 1978
SALISBURY MD
21802-1978
US
V. Phone/Fax
- Phone: 443-358-6193
- Fax: 443-358-6197
- Phone: 410-749-1015
- Fax: 410-749-0654
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | SC2305 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | 31608 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: