Provider Demographics
NPI:1154188019
Name:SHELTON, RACHEL ELIZABETH (LMSW, CSC-AD)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:SHELTON
Suffix:
Gender:F
Credentials:LMSW, CSC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1978
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21802-1978
Mailing Address - Country:US
Mailing Address - Phone:410-749-1015
Mailing Address - Fax:410-749-0654
Practice Address - Street 1:560 RIVERSIDE DR STE A204
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-4704
Practice Address - Country:US
Practice Address - Phone:443-358-6193
Practice Address - Fax:443-358-6197
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSC2305101YA0400X
MD31608104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119591300Medicaid