MEDICARE: MISS SHELLY MARLENE BYRD MENTAL HEALTH WORKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker
2	225C00000X	Rehabilitation Counselor

General Provider Information

NPI Number	:	1578621819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SHELLY MARLENE BYRD MENTAL HEALTH WORKER

Provider Business Mailing Address
First Line	:	592 RIO LINDO AVE
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95926-1817
Country	:	US
Telephone Number	:	530-891-2775
Fax Number	:

Provider Business Practice Location Address
First Line	:	592 RIO LINDO AVE
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95926-1817
Country	:	US
Telephone Number	:	530-891-2775
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	09/11/2025

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