Active NPI
Shannel Ezedi, LPCI
- Mental Health Counselor
- Beaufort, SC
National Provider Identifier
1235655101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1050 Ribaut Rd
Beaufort, SC 29902-5400 - Phone
- (857) 540-2095
- NPI assigned
- Aug 22, 2017
- Sex
- Female
- 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 | Primary |
Addresses
Primary practice location
1050 Ribaut Rd
Beaufort, SC 29902-5400
Mailing address
1050 Ribaut Rd
Beaufort, SC 29902-3679
Phone (843) 473-6355
Other practice location 1
12 Fairfield Rd Ste B3
Beaufort, SC 29907-2576
Phone (857) 540-2095
Other names 1
- Ms. Shannel Ezedi
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 14, 2026 through Feb 14, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tanya L. Hilber, PSYD | Past | Accepting new patients | |
| Hilber Psychological Services a Professional Corporation | Mental Health | Past | 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.
-
- Psychologist
- San Diego, CA
- NPI 1528822434
Mental Health
-
- Clinical Psychologist
- San Diego, CA
- NPI 1962807628
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1235655101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 RIBAUT RD",
"city": "BEAUFORT",
"state": "SC",
"postal_code": "299023679",
"telephone_number": "843-473-6355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 RIBAUT RD",
"city": "BEAUFORT",
"state": "SC",
"postal_code": "299025400",
"telephone_number": "857-540-2095"
}
],
"practiceLocations": [
{
"address_1": "12 Fairfield Rd Ste B3",
"address_purpose": "LOCATION",
"city": "Beaufort",
"state": "SC",
"postal_code": "299072576",
"country_code": "US",
"telephone_number": "857-540-2095",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EZEDI",
"first_name": "SHANNEL",
"credential": "LPCI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-08-22",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHANNEL",
"last_name": "EZEDI",
"prefix": "MS.",
"credential": "ED.S., LPCI",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Beaufort, SC
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.