Individual provider Active NPI

Shelby Whiting, LPC

  • Professional Counselor
  • Ammon, ID
National Provider Identifier
1154139509
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-9216 Issued in ID
Practice address
1329 Ammon Park Dr
Ammon, ID 83406-4591
Phone
(208) 569-8599
NPI assigned
Dec 18, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X LPC-9216 ID Primary

Addresses

Primary practice location

1329 Ammon Park Dr
Ammon, ID 83406-4591

Mailing address

1329 Ammon Park Dr
Ammon, ID 83406-4591
Phone (208) 569-8599

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 18, 2024 through Dec 18, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC-9216IDMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1734480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1154139509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 AMMON PARK DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834064591",
            "telephone_number": "208-569-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 AMMON PARK DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834064591",
            "telephone_number": "208-569-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITING",
        "first_name": "SHELBY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-18",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LPC-9216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ammon, ID

Sources for this page

Verify at the official NPI Registry.