=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134463524
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHELMESHIA HILL-BROWN MSW, LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/26/2012
-----------------------------------------------------
Last Update Date | 08/26/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 115 COASTAL WAY
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23320-4603
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-609-3115
-----------------------------------------------------
Fax | 800-850-8627
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1425 BATTLEFIELD BLVD N # 1027
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23320-4585
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-609-3115
-----------------------------------------------------
Fax | 800-850-8627
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | C009219
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 0904009672
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------