Individual provider Active NPI

Shelley M Barber, PHD

  • Psychologist
  • Seattle, WA
National Provider Identifier
1013532274
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY61097748 Issued in WA
Practice address
4126 E Madison St Ste 204
Seattle, WA 98112-3345
Phone
(206) 926-9901
NPI assigned
Jun 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY61097748 WA Primary

Addresses

Primary practice location

4126 E Madison St Ste 204
Seattle, WA 98112-3345

Mailing address

5505 44TH CT SE
Lacey, WA 98503-4351
Phone (865) 805-0425

Other practice location 1

1005 Olympia Ave NE
Olympia, WA 98506-4033
Phone (206) 486-0150

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY61097748WAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Karen Pavlidis PLLC CurrentSince Jun 12, 2022 Accepting new patients

Locations

4126 E Madison St
Ste 204
Seattle, WA 98112
Phone (206) 926-9901

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1013532274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 44TH CT SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985034351",
            "telephone_number": "865-805-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4126 E MADISON ST STE 204",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981123345",
            "telephone_number": "206-926-9901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Olympia Ave NE",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985064033",
            "country_code": "US",
            "telephone_number": "206-486-0150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARBER",
        "first_name": "SHELLEY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-13",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY61097748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.