Healthcare Provider Details

I. General information

NPI: 1871048876
Provider Name (Legal Business Name): SHELLEY EILEEN BECKLEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2016
Last Update Date: 10/13/2026
Certification Date: 10/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 N MISSOURI ST
MACON MO
63552-2143
US

IV. Provider business mailing address

1847 HIGHWAY K
CLARENCE MO
63437-3015
US

V. Phone/Fax

Practice location:
  • Phone: 660-395-9114
  • Fax:
Mailing address:
  • Phone: 660-651-4120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWI.LW.70160171
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2019003938
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: