Jessica Lyn Shultis

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

8436 Issued in CT

Practice address

11 Woodland Rd Ste 2
Madison, CT 06443-2380

Phone

(203) 208-8996

NPI assigned

Jun 11, 2025

Last updated

Jun 11, 2025By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michelle M Reynolds, PHD, LLC

  dba LifeCatalyst

  • Clinical Psychologist
  • Madison, CT
  • NPI 1467037143

  Professional

  NPD

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

{
    "created_epoch": "1749600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1316832116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 ROYAL OAK DR",
            "city": "DURHAM",
            "state": "CT",
            "postal_code": "064221410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 WOODLAND RD STE 2",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432380",
            "telephone_number": "203-208-8996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTIS",
        "first_name": "JESSICA",
        "middle_name": "LYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-11",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "8436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shoreline Medical Associates LLC
• Shoreline Pediatrics & Adolescent Medicine, P.C.
• Shoreline Psychological
• Shoreline Psychotherapy Crisis and Consultation Center LLC
• Shoreline Speech Therapy
• Lillian Siegel, CNM
• Marisa Kelsey Sierra, LMFT
• Joseph M Slater, P.A.
• Adrienne G Smaller, PH.D.
• Keiren Donovan Smith, M.D.

• Professional Counselor in Madison, CT
• Providers in Madison, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.