Healthcare Provider Details

I. General information

NPI: 1982185203
Provider Name (Legal Business Name): SHELBY BROOKE COMBS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHELBY BROOKE SMITH LCSW

II. Dates (important events)

Enumeration Date: 08/24/2018
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1119 E WEST HWY
SILVER SPRING MD
20910-4852
US

IV. Provider business mailing address

17485 CASHEW LN
DIXON MO
65459-8236
US

V. Phone/Fax

Practice location:
  • Phone: 888-879-9788
  • Fax:
Mailing address:
  • Phone: 915-801-5499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number25987
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: