Kerrie A Shively

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701016236 Issued in VA

Practice address

1158 Professional Dr Ste G
Williamsburg, VA 23185-6618

Phone

(757) 349-6463

NPI assigned

Jun 1, 2026

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

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.

• Authentic Self Association LLC

  • Clinical Social Worker
  • Williamsburg, VA
  • NPI 1720854466
  NPD

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

{
    "created_epoch": "1780272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1134051634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1158 PROFESSIONAL DR STE G",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231856618",
            "telephone_number": "757-349-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1158 PROFESSIONAL DR STE G",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231856618",
            "telephone_number": "757-349-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIVELY",
        "first_name": "KERRIE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701016236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shane Andrew Sheffield, MS.ED.
• Bobby Leonard Shelton II, MD
• John Murdaugh Shepherd Jr., DDS
• Krita Sheth, ANP-BC
• Stephen Wyatt Shield, M.D.
• Grace Delk Shortt, LCSW
• Michael C. Shuck, D.D.S.
• Eric Roy Shuey, BCBA
• Avani Siddhapura, OD
• Mohammad Siddiqui, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.