Individual provider Active NPI

Shelby Rose Cantley, LPCC-S

  • Professional Counselor
  • Sandusky, OH
National Provider Identifier
1174041503
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.1901563 Issued in OH
Practice address
1925 Hayes Ave
Sandusky, OH 44870-4737
Phone
(419) 557-5162
Fax
(419) 557-5179
NPI assigned
Sep 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C.1700647 OH
Professional Counselor 101YP2500X E.1901563 OH Primary

Addresses

Primary practice location

1925 Hayes Ave
Sandusky, OH 44870-4737

Mailing address

1925 Hayes Ave
Sandusky, OH 44870-4737
Phone (419) 557-5177

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
I20240117002213 OH Practitioner - Mental Health Counselor 0840642625 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.1700647OHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Firelands Regional Medical Center PastSince Jan 1, 2024 Accepting new patients

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": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1174041503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 HAYES AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704737",
            "telephone_number": "419-557-5177",
            "fax_number": "419-557-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 HAYES AVE",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448704737",
            "telephone_number": "419-557-5162",
            "fax_number": "419-557-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTLEY",
        "first_name": "SHELBY",
        "middle_name": "ROSE",
        "credential": "LPCC-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "C.1700647",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1901563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, OH

Sources for this page

Verify at the official NPI Registry.