Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shayne Kelly Wilson

Individual provider Social Worker · NPI 1396563995

Shayne Kelly Wilson is a Social Worker in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2024.

Licensed in
MI
In the registry since
2024

Practice location Address checks out

1115 Ball Ave NE
Grand Rapids, MI 49505-5904
Phone: (616) 451-3001
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X (MI)

Record details

NPI number1396563995
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 1, 2024
Last updated in NPPESOctober 1, 2024
Certification dateOctober 1, 2024

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