Shelby Coshetta Teasley, QMHP-A,C

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

7300 Hanover Green Dr Ste 300-a
Mechanicsville, VA 23111-1705

Phone

(804) 497-9064

NPI assigned

Jan 13, 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

Other names 1

• Mr. Wayne Breedlove Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• A Tiny Ripple of Hope, LLC

  • Community/Behavioral Health Agency
  • Henrico, VA
  • NPI 1023764529
  NPD Authorized official

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

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1093466872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 HANOVER GREEN DR STE 300-A",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231111705",
            "telephone_number": "804-497-9064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 HANOVER GREEN DR STE 300-A",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231111705",
            "telephone_number": "804-497-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEASLEY",
        "first_name": "SHELBY",
        "middle_name": "COSHETTA",
        "name_prefix": "Ms.",
        "credential": "QMHP-A,C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WAYNE",
            "last_name": "BREEDLOVE",
            "prefix": "MR.",
            "credential": "QMHP,A,C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lisa Taylor, OTR/L
• Mayah Taylor, LPC
• Sara E Taylor
• Sophia Frances Taylor I, BEHAVIOR TECHNICIAN
• Ta'Tiana Taylor
• Mesfin A Tefera, MD
• Jamie Lynn Temple, NP
• Sherwyn Shane Tenia
• Christopher R Testa, OD
• The Healing Collaborative, PLLC

• Professional Counselor in Mechanicsville, VA
• Providers in Mechanicsville, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.