Shelley Beth Kingsbury, LCSW
NPI 1104462654ActiveIndividual· Social Worker, Clinical· Mystic, CT
Social Worker, Clinical (LCSW) in Mystic, Connecticut, trained at Fordham University School of Medicine (class of 2016). Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1104462654 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW |
| Sole proprietor | Yes |
| NPI issued | Nov 20, 2019 |
| Last updated in NPPES | Aug 26, 2021 |
| Certified by provider | Aug 26, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 010666 | CT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (CT) |
|---|
Education and affiliations
| Medical school | Fordham University School of Medicine |
|---|---|
| Graduation year | 2016 |
| Medicare specialty | Clinical Social Worker |
Medical group
- State of ConnecticutMiddletown, CT · 260 clinicians
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All 30 clinical social workers in Mystic · All clinical social workers in Connecticut