Provider Demographics
NPI:1194206607
Name:SHELTON, DIONA RANEE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DIONA
Middle Name:RANEE
Last Name:SHELTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CAROLYN ST
Mailing Address - Street 2:
Mailing Address - City:GLEN CARBON
Mailing Address - State:IL
Mailing Address - Zip Code:62034-1940
Mailing Address - Country:US
Mailing Address - Phone:618-744-0844
Mailing Address - Fax:
Practice Address - Street 1:189 E US HIGHWAY 40 STE D
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:IL
Practice Address - Zip Code:62294-2267
Practice Address - Country:US
Practice Address - Phone:618-744-0844
Practice Address - Fax:618-505-5044
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0197781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical