Individual provider Active NPI

Shellagh R Marshall-Young, CAS II

  • Addiction (Substance Use Disorder) Counselor
  • Orange, CA
National Provider Identifier
1013290253
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
01-040566 Issued in CA
Practice address
812 W Town and Country Rd
Orange, CA 92868-4712
Phone
(714) 547-6494
Fax
(714) 547-9990
NPI assigned
Sep 23, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 01-040566 CA Primary

Addresses

Primary practice location

812 W Town and Country Rd
Orange, CA 92868-4712

Mailing address

812 W. Town and Country Rd
Orange, CA 92868-4712
Phone (171) 454-7649

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
01-040566CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1013290253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 W. TOWN AND COUNTRY RD",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684712",
            "telephone_number": "171-454-7649",
            "fax_number": "171-454-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 W TOWN AND COUNTRY RD",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684712",
            "telephone_number": "714-547-6494",
            "fax_number": "714-547-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL-YOUNG",
        "first_name": "SHELLAGH",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "CAS II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-23",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "01-040566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.