| Mrs Diona Ranee Shelton, LCSW | |
|
189 E Us Highway 40 Ste D, Troy, IL 62294-2267 | |
| (618) 744-0844 | |
| (618) 505-5044 |
| Full Name | Mrs Diona Ranee Shelton |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 189 E Us Highway 40 Ste D, Troy, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194206607 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149.019778 (Illinois) | Primary |
| Entity Name | Brightside Medical Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801355482 PECOS PAC ID: 6608262464 Enrollment ID: O20230403000549 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Diona Ranee Shelton, LCSW 8 Carolyn St, Glen Carbon, IL 62034-1940 Ph: (618) 744-0844 | Mrs Diona Ranee Shelton, LCSW 189 E Us Highway 40 Ste D, Troy, IL 62294-2267 Ph: (618) 744-0844 |
Tracy Lewis, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 189 E Us Highway 40 Ste D, Troy, IL 62294 Phone: 773-562-0672 | |
Andrea Shaw, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 552 Edwardsville Rd, Troy, IL 62294 Phone: 618-520-6963 | |
Amy Haerr, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1424 Bridgehampton Rd, Troy, IL 62294 Phone: 302-404-4617 |