Active NPI
Shelley Louise Jungen, LPC
- Professional Counselor
- Lebanon, MO
National Provider Identifier
1093071003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2009035450
- Practice address
- 860 Lynn St
Lebanon, MO 65536-3810 - Phone
- (888) 403-1071
- NPI assigned
- Apr 3, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2009035450 | MO | Primary |
Addresses
Primary practice location
860 Lynn St
Lebanon, MO 65536-3810
Mailing address
1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131
Other names 1
- Shelley Louise Grubbs
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009035450 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Achieve Balance Counseling, LLC | Professional | Current | Accepting new patients |
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": "1333411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611878400000",
"number": "1093071003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 COMMUNITY",
"city": "CLINTON",
"state": "MO",
"postal_code": "647358804",
"telephone_number": "660-885-8131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "860 LYNN ST",
"city": "LEBANON",
"state": "MO",
"postal_code": "655363810",
"telephone_number": "888-403-1071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUNGEN",
"first_name": "SHELLEY",
"middle_name": "LOUISE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-03",
"last_updated": "2021-01-29",
"certification_date": "2021-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2009035450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHELLEY",
"last_name": "GRUBBS",
"middle_name": "LOUISE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lebanon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.