Individual provider Active NPI

Shelley Horine, LPC

  • Mental Health Counselor
  • Perrysburg, OH
National Provider Identifier
1154735678
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C.1300339 Issued in OH
Practice address
26471 Southpoint Rd
Perrysburg, OH 43551-1371
Phone
(419) 482-8382
NPI assigned
Jun 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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 C.1300339 OH Primary

Addresses

Primary practice location

26471 Southpoint Rd
Perrysburg, OH 43551-1371

Mailing address

26471 Southpoint Rd
Perrysburg, OH 43551-1371
Phone (419) 482-8382

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241008002581 OH Practitioner - Mental Health Counselor 9436680998 Practice locations: Perrysburg, OH

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

115 W Front St
Suite 8
Perrysburg, OH 43551-1473
Phone (419) 910-2638

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1300339OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pathway to Serenity CurrentSince Aug 30, 2020 Accepting new patients
Perrysburg Counseling Services, LLC Mental Health Past Accepting new patients

Locations

115 W Front St
Ste 8
Perrysburg, OH 43551
Phone (419) 910-2638

Organizations & group practices 2

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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1154735678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26471 SOUTHPOINT RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511371",
            "telephone_number": "419-482-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26471 SOUTHPOINT RD",
            "city": "PERRYSBURG",
            "state": "OH",
            "postal_code": "435511371",
            "telephone_number": "419-482-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORINE",
        "first_name": "SHELLEY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.1300339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perrysburg, OH

Sources for this page

Verify at the official NPI Registry.