Active NPI
Eugene Shelly, M.DIV.
- Mental Health Counselor
- New York, NY
National Provider Identifier
1205024205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 002495-1
- Practice address
- 145 Central Park W Apt 1a
New York, NY 10023-2004 - Phone
- (212) 721-6660
- NPI assigned
- Oct 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 002495-1 | NY | Primary |
Addresses
Primary practice location
145 Central Park W Apt 1a
New York, NY 10023-2004
Mailing address
3234 Irwin Ave
Bronx, NY 10463-3705
Phone (718) 543-7670
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
| License | State | Type | Specialty |
|---|---|---|---|
| 002495-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191456000000",
"number": "1205024205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3234 IRWIN AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104633705",
"telephone_number": "718-543-7670",
"fax_number": "718-543-7670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 CENTRAL PARK W APT 1A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100232004",
"telephone_number": "212-721-6660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELLY",
"first_name": "EUGENE",
"credential": "M.DIV.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-04",
"last_updated": "2007-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "002495-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
- Benjamin Shelling, DMD
- Farrah Cindy Shellow, M.S.ED., R.C.
- Rahshima Shells, LMHC
- Shelly Menolascino MD, LLC
- Shelly Rosen LCSW PC
- Danielle V Shelov
- Sheltering Arms Children & Family Services, Inc
- Sheltering Arms Children & Family Services, Inc
- Sheltering Arms Children & Family Services, Inc
- Sheltering Arms Children and Family Services Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.