Individual provider Active NPI

Laura Kachinko Shely, M.A., LMFT-A

  • Marriage & Family Therapist
  • Houston, TX
National Provider Identifier
1023389509
Registry record updated Jan 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
201720 Issued in TX
Practice address
1807 Lexington St
Houston, TX 77098-4303
Phone
(713) 851-7932
NPI assigned
Jan 16, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 201720 TX Primary

Addresses

Primary practice location

1807 Lexington St
Houston, TX 77098-4303

Mailing address

5619 Grape St
Houston, TX 77096-1113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240514002664 TX Practitioner - Marriage and Family Therapist 2062853666 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
201720TXMDSurgical Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Marriage & Family Therapist CurrentSince Apr 10, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

700 Milam St
Ste 1300
Houston, TX 77002
Phone (281) 801-8391

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": "1326672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326672000000",
    "number": "1023389509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5619 GRAPE ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770961113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 LEXINGTON ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770984303",
            "telephone_number": "713-851-7932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELY",
        "first_name": "LAURA",
        "middle_name": "KACHINKO",
        "name_prefix": "Ms.",
        "credential": "M.A., LMFT-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-16",
        "last_updated": "2012-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "201720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.