Healthcare Provider Details

I. General information

NPI: 1295841559
Provider Name (Legal Business Name): RONALD L SHELTON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 03/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 UNIVERSITY BLVD
HARRISONBURG VA
22801-3750
US

IV. Provider business mailing address

PO BOX 1430
HARRISONBURG VA
22803-1430
US

V. Phone/Fax

Practice location:
  • Phone: 540-564-5960
  • Fax: 540-433-4338
Mailing address:
  • Phone: 540-437-7989
  • Fax: 540-437-7984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904003058
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: