=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417206574
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERICA M SHELL LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/05/2012
-----------------------------------------------------
Last Update Date | 08/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 126 CREEKSIDE LN
-----------------------------------------------------
City | WINCHESTER
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22602-2429
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-990-1744
-----------------------------------------------------
Fax | 434-939-9401
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8767 SEMINOLE TRL STE 101
-----------------------------------------------------
City | RUCKERSVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22968-3494
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-990-1744
-----------------------------------------------------
Fax | 434-939-9401
-----------------------------------------------------
=====================================================
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 | 0904013782
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | BP00943829
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------