MS. SHAYNA KELLEHER L.C.S.W.
NPI 1205170040
Social Worker - Clinical in San Diego, CA

Active since November 17, 2012Opted out of Medicare · through Nov 1, 2027
5252 BALBOA AVE, SAN DIEGO, CA 92117(858) 598-3818 Get Directions Write a Review

NPPES record last updated: November 17, 2012. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ms. Shayna Kelleher L.c.s.w. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. SHAYNA KELLEHER L.C.S.W. (NPI 1205170040) is an individual clinical provider in San Diego, California, licensed in California (LCS27620) and active in the NPI registry since November 2012. She has opted out of Medicare through November 1, 2027.

NPPES Registry Identity

NPI1205170040
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMS. SHAYNA KELLEHERCredential: L.C.S.W.
Location Address5252 BALBOA AVESan Diego, CA 92117-6906
Mailing Address5252 Balboa Ave, Suite 803San Diego, CA 92117-6906 · (858) 598-3818
Sole ProprietorYes
Enumeration DateNovember 17, 2012
NPI 1205170040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in CA · LCS27620
Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

5252 BALBOA AVE, San Diego, CA 92117

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Ms. Shayna Kelleher L.c.s.w. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 1, 2023 through November 1, 2027.

Opt-Out Effective DateNovember 1, 2023
Opt-Out In Effect ThroughNovember 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Chiropractor
5252 BALBOA AVE, SUITE 901
SAN DIEGO, CA 92117
Chiropractor (Sports Physician)
5252 BALBOA AVE, STE. 901
SAN DIEGO, CA 92117
Psychologist
5252 BALBOA AVE, SUITE 209
SAN DIEGO, CA 92117
Marriage & Family Therapist
5252 BALBOA AVE, SUITE 209
SAN DIEGO, CA 92117
Marriage & Family Therapist
5252 BALBOA AVE, SUITE 707
SAN DIEGO, CA 92117
Chiropractor
5252 BALBOA AVE, STE 901
SAN DIEGO, CA 92117
Chiropractor
5252 BALBOA AVE, SUITE 1002
SAN DIEGO, CA 92117
Psychologist (Clinical)
5252 BALBOA AVE, #802
SAN DIEGO, CA 92117

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shayna Kelleher's NPI number?

The NPI number for Shayna Kelleher is 1205170040. It was assigned to this individual provider in the NPPES registry on November 17, 2012.

Where is Shayna Kelleher located?

Shayna Kelleher practices at 5252 Balboa Ave, San Diego, CA 92117. The listed phone number is (858) 598-3818.

What is Shayna Kelleher's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Shayna Kelleher enrolled in Medicare?

No. Shayna Kelleher has opted out of Medicare through November 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Shayna Kelleher was last updated on November 17, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.