Active NPI
Shelbie Broach
- Mental Health Counselor
- Rock Hill, SC
National Provider Identifier
1356077101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11154
- Practice address
- 1420 Ebenezer Rd Ste 101
Rock Hill, SC 29732-2774 - Phone
- (803) 619-9055
- NPI assigned
- Jul 25, 2022
- Last updated
- Nov 25, 2025
- 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 | 11154 | SC | Primary |
Addresses
Primary practice location
1420 Ebenezer Rd Ste 101
Rock Hill, SC 29732-2774
Mailing address
122 Sioux CT
Summerville, SC 29483-9264
Phone (843) 729-9820
Other practice location 1
111 Mackenan Dr
Cary, NC 27511-7903
Phone (919) 371-2848
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11154 | SC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764028800000",
"number": "1356077101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 SIOUX CT",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294839264",
"telephone_number": "843-729-9820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 EBENEZER RD STE 101",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297322774",
"telephone_number": "803-619-9055"
}
],
"practiceLocations": [
{
"address_1": "111 Mackenan Dr",
"address_purpose": "LOCATION",
"city": "Cary",
"state": "NC",
"postal_code": "275117903",
"country_code": "US",
"telephone_number": "919-371-2848",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROACH",
"first_name": "SHELBIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-25",
"last_updated": "2025-11-25",
"certification_date": "2025-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "SC",
"license": "11154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rock Hill, SC
- Bridgebuilders Family & Youth Services Inc.
- Lisa Grey Bridgewater, PH.D.
- Bright Eyes & Optical
- Bright Goals Counseling & Academic Services
- Perdina Brisbon
- Broken Better Urgent Care LLC (Broken To Better Urgent Care)
- Brookdale Senior Living Communities, Inc. (Brookdale Ebenezer Road)
- Jessica Hollen Brooks, MED, LPC, LCMHCA
- Sheri Paige Broom, RN, BSN
- Kristen Broome, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.