Individual provider Active NPI

Jules Shellby, LPC

  • Mental Health Counselor
  • Traverse City, MI
National Provider Identifier
1144790429
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401014158 Issued in MI
Practice address
812 S Garfield Ave Ste J
Traverse City, MI 49686-3456
Phone
(231) 259-5649
NPI assigned
Nov 29, 2018
Last updated
Nov 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401014158 MI Primary

Addresses

Primary practice location

812 S Garfield Ave Ste J
Traverse City, MI 49686-3456

Mailing address

812 S Garfield Ave Ste J
Traverse City, MI 49686-3456
Phone (231) 259-5649

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

LicenseStateTypeSpecialty
6401014158MIMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1144790429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 S GARFIELD AVE STE J",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863456",
            "telephone_number": "231-259-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 S GARFIELD AVE STE J",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863456",
            "telephone_number": "231-259-5649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLBY",
        "first_name": "JULES",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401014158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.