Shelbi Raelynne Gabbard, LMHCA, ATR-P

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6352001211 Issued in MI

Practice address

2118 3 Mile Rd NW
Grand Rapids, MI 49544-1425

Phone

(616) 222-3720

Fax

(616) 222-3724

NPI assigned

Jan 6, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Shelbi Raelynne Tidd 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.

• Blooming Emotions LLC

  • Adult Mental Health Clinic/Center
  • Noblesville, IN
  • NPI 1952000176
  NPD Authorized official

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1053072520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 3 MILE RD NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495441425",
            "telephone_number": "616-222-3720",
            "fax_number": "616-222-3724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6500 Byron Center Ave SW",
            "address_purpose": "LOCATION",
            "city": "Byron Center",
            "state": "MI",
            "postal_code": "493159080",
            "country_code": "US",
            "telephone_number": "616-281-6382",
            "fax_number": "616-281-6397",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 68th St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495486927",
            "country_code": "US",
            "telephone_number": "616-258-7467",
            "fax_number": "616-258-7432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GABBARD",
        "first_name": "SHELBI",
        "middle_name": "RAELYNNE",
        "credential": "LMHCA, ATR-P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-06",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39004402A",
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6352001211",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "88001233A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBI",
            "last_name": "TIDD",
            "middle_name": "RAELYNNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Lillian Lou Gaastra, PA-S
• Marylynn Joanna Gaastra, PA
• Stephanie Gabbard
• Makenna Grace Gable
• Caryn Gabrek, RN
• Amy Gackenheimer, PHARMD
• Ramakrishnayya Gadam, M.D.

• Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.