Shelli Rae Carpenter, LPCA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

272705 Issued in KY

Practice address

214 Breckenridge LN Ste 114
Louisville, KY 40207-3868

Phone

(502) 653-7211

Fax

(502) 416-0723

NPI assigned

Nov 3, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shelli Rae Ridener Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Renew Counseling, LLC

  • Community/Behavioral Health Agency
  • Louisville, KY
  • NPI 1437699428
  NPD

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

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1043083801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 BRECKENRIDGE LN STE 114",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073868",
            "telephone_number": "502-653-7211",
            "fax_number": "502-416-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 BRECKENRIDGE LN STE 114",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402073868",
            "telephone_number": "502-653-7211",
            "fax_number": "502-416-0723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "SHELLI",
        "middle_name": "RAE",
        "credential": "LPCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "272705",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "272705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLI",
            "last_name": "RIDENER",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jordan Leigh Carpenter, LPAT, ATR-BC
• Kimberly Beth Carpenter, D.C.
• Patrice Ann Carpenter, BS
• Rebecca Carpenter
• Robin Carpenter
• Susan Sullivan Carpenter, M.A.CCC SLP
• Tiffany Dawn Carpenter, FNP-BC
• Victoria Kay Carpenter, MD, PHD
• Dinah Christine Carr
• Jorie Nicole Carr

• Professional Counselor in Louisville, KY
• Providers in Louisville, KY by specialty
• Professional Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.