Shelly Antoinette Jeter, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

012812 Issued in NY

Practice address

114 5TH Ave
New York, NY 10011-5604

Phone

(215) 440-6626

NPI assigned

Sep 9, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1023739844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 ELM ST",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117224146",
            "telephone_number": "631-334-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115604",
            "telephone_number": "215-440-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETER",
        "first_name": "SHELLY",
        "middle_name": "ANTOINETTE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-09",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "012812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne Jester, FNP-BC
• Arun Jesudian, MD
• Jesus M. Hernandez, M.D., P.C.
• Cortlyn Jeter, MD
• Keyona Darje' Jeter, FNP-BC
• Daniel Jethanamest, M.D.
• Nitin Jethmalani, MD
• Jasmine Farisha Jethwa, OD
• Jetlenses Inc
• Nathalie Jette, MD MSC FRCPC

• Mental Health Counselor in New York, NY
• Providers in New York, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.