Individual provider Active NPI

Shelbi Raylene Callahan, ASW

  • Mental Health Counselor
  • Santee, CA
National Provider Identifier
1205355963
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
ASW71912 Issued in CA
Practice address
10201 Mission Gorge Rd Ste O
Santee, CA 92071-3027
Phone
(619) 383-6868
Fax
(619) 312-2661
NPI assigned
Sep 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 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 ASW71912 CA Primary

Addresses

Primary practice location

10201 Mission Gorge Rd Ste O
Santee, CA 92071-3027

Mailing address

5757 Lake Murray Blvd Apt 142
La Mesa, CA 91942-2202
Phone (661) 809-4399

Other practice location 1

5538 University Ave
San Diego, CA 92105-2307
Phone (619) 229-4202

Other practice location 2

5538 University Ave
San Diego, CA 92105-2307
Phone (619) 229-4202

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
ASW71912CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1205355963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 LAKE MURRAY BLVD APT 142",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422202",
            "telephone_number": "661-809-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 MISSION GORGE RD STE O",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920713027",
            "telephone_number": "619-383-6868",
            "fax_number": "619-312-2661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5538 University Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921052307",
            "country_code": "US",
            "telephone_number": "619-229-4202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5538 University Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921052307",
            "country_code": "US",
            "telephone_number": "619-229-4202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "SHELBI",
        "middle_name": "RAYLENE",
        "credential": "ASW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW71912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.