Tess Diane Shellenbarger, LCPC, LPC, MAC, CADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C2456 Issued in OR

Practice address

390 NE 2ND St
Ontario, OR 97914-2513

Phone

(541) 889-1050

Fax

(541) 889-6524

NPI assigned

Oct 25, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• TFP Therapeutic Service, Inc.

  • Mental Health Counselor
  • Ontario, OR
  • NPI 1467666024
  NPD (past) Authorized official
• The Family Place D/B/a TFP Services Therapeutic

  • Mental Health Counselor
  • Ontario, OR
  • NPI 1467925420
  NPD (past) Authorized official

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1083990832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX V",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979140076",
            "telephone_number": "541-889-1050",
            "fax_number": "541-889-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 NE 2ND ST",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142513",
            "telephone_number": "541-889-1050",
            "fax_number": "541-889-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLENBARGER",
        "first_name": "TESS",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "LCPC, LPC, MAC, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C2456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LINCENSED PROFESSIONAL COUNSELOR",
            "identifier": "C2456",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Yvonne Sederberg
• Annette Serrano
• Misty Shaffer
• Marci Shaw
• Sheibani LLC
• Sandra I Shelton, QMHP
• Devona Lynn Shepard
• Gabierelle Ann Sherry
• Madison Shira
• Byron Mitchell Shock

• Mental Health Counselor in Ontario, OR
• Providers in Ontario, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; 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.