Individual provider Active NPI

Demi Jo Shetler

  • Mental Health Counselor
  • North Liberty, IA
National Provider Identifier
1003728296
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
118820 Issued in IA
Practice address
575 Cameron Way Ste a
North Liberty, IA 52317-4734
Phone
(319) 626-2558
NPI assigned
Sep 21, 2026
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 118820 IA Primary

Addresses

Primary practice location

575 Cameron Way Ste a
North Liberty, IA 52317-4734

Mailing address

575 Cameron Way Ste a
North Liberty, IA 52317-4734
Phone (319) 626-2558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1789948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1003728296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 CAMERON WAY STE A",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523174734",
            "telephone_number": "319-626-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 CAMERON WAY STE A",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523174734",
            "telephone_number": "319-626-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETLER",
        "first_name": "DEMI",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-21",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "118820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.