Provider Demographics
NPI:1326566969
Name:SCHILLER, SHELBY (LCSW)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:SCHILLER
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5651 E SIERRA MORENA ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-7809
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:
Practice Address - Street 1:3303 E BASELINE RD STE 111
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2739
Practice Address - Country:US
Practice Address - Phone:801-655-5450
Practice Address - Fax:385-225-9327
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-04
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099300251041C0700X
WALW615060811041C0700X
WI11530-1231041C0700X
CALCSW1212751041C0700X
NV8562-C1041C0700X
TX11230071041C0700X
UT13681244-35011041C0700X
NV7197-S1041C0700X
AZLCSW-207921041C0700X
FLSW224801041C0700X
IDLCSW-444941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCSW.09930025OtherLICENSE
NV8562-COtherLICENSE
AZLCSW-20792OtherLICENSE
IDLCSW-44494OtherLICENSE
WALW61506081OtherLICENSE
TX1123007OtherLICENSE
UT13681244-3501OtherLICENSE
CALCSW121275OtherLICENSE
WI11530-123OtherLICENSE
NVIC1139OtherLICENSE
FLSW22480OtherLICENSE