=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184312456
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MASHELL A. SCHELL, LCSW, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2023
-----------------------------------------------------
Last Update Date | 07/07/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 420 N MAIN ST
-----------------------------------------------------
City | WARSAW
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14569-9347
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-616-3366
-----------------------------------------------------
Fax | 585-757-2463
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8351 LEWISTON ROAD SUITE 3, PMB# 317
-----------------------------------------------------
City | BATAVIA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14020-4074
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-616-3366
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MASHELL A. SCHELL
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 585-616-3366
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------