Individual provider Active NPI

Shelley Elizabeth Freeman, MS, LPC

  • Professional Counselor
  • Jacksonville, NC
National Provider Identifier
1215057625
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8513 Issued in NC
Practice address
250 Huff Dr
Jacksonville, NC 28546-7369
Phone
(910) 353-4414
Fax
(910) 353-2972
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 8513 NC Primary

Addresses

Primary practice location

250 Huff Dr
Jacksonville, NC 28546-7369

Mailing address

250 Huff Dr
Jacksonville, NC 28546-7369
Phone (910) 353-4414

Other identifiers 1

IdentifierTypeStateIssuer
8513OtherNCNORTH CAROLINA BOARD OF LICENSED PROFESSIONAL COUNSELORS

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8513NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Johnston Pain Management PA PastSince Oct 1, 1996 Accepting new patients

Organizations & group practices 1

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1215057625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 HUFF DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467369",
            "telephone_number": "910-353-4414",
            "fax_number": "910-353-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 HUFF DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467369",
            "telephone_number": "910-353-4414",
            "fax_number": "910-353-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "SHELLEY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "8513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA BOARD OF LICENSED PROFESSIONAL COUNSELORS",
            "identifier": "8513",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; 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.