Healthcare Provider Details

I. General information

NPI: 1982841458
Provider Name (Legal Business Name): SHELBY LEE CRESPO ND, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2009
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4111 BARKER DR
CLIO MI
48420-9480
US

IV. Provider business mailing address

4111 BARKER DR
CLIO MI
48420-9480
US

V. Phone/Fax

Practice location:
  • Phone: 810-210-2509
  • Fax:
Mailing address:
  • Phone: 810-210-2509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149018329
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number6095-170
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number4385
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: