Shaun Mykel Phelps, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH11568 Issued in FL

Practice address

2711 W 15TH St
Panama City, FL 32401-1366

Phone

(850) 769-6001

Fax

(850) 769-6003

NPI assigned

Jan 8, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Life Management Center of NW FL, Inc.

  • Psychiatry Physician
  • Panama City, FL
  • NPI 1508854571
  Medicare reassignment NPD
• Life Management Center of Northwest Florida Inc

  • Psychiatry Physician
  • Blountstown, FL
  • NPI 1659301877
  NPD
• Life Management of NW FL, Inc.

  • Psychiatry Physician
  • Marianna, FL
  • NPI 1255367579
  NPD
• Compass Health, Inc

  • Community/Behavioral Health Agency
  • Clinton, MO
  • NPI 1285619494
  NPD (past)

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

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1275870495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 GRACE AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324012756",
            "telephone_number": "850-215-6007",
            "fax_number": "850-215-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 W 15TH ST",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324011366",
            "telephone_number": "850-769-6001",
            "fax_number": "850-769-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "SHAUN",
        "middle_name": "MYKEL",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordyn Leigh Petrone
• Shellie Peuhs, LMT
• Brandi Lynn Pfuntner
• Priscilla Phelan
• Mackenzie Renae Phelps, RBT
• Phillip H Nunnery MD PA
• Julia Marie Phillips
• Paul Kenneth Phillips, MD
• Warren Phillips, RPH
• Albert Michael Pickle, R, MR

• Mental Health Counselor in Panama City, FL
• Providers in Panama City, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.