Individual provider Active NPI

Marie Luise Shelton, LCMHCA

  • Professional Counselor
  • Southern Shores, NC
National Provider Identifier
1366060402
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
A15824 Issued in NC
Practice address
12 Juniper TRL Ste 201
Southern Shores, NC 27949-3750
Phone
(252) 512-4245
NPI assigned
Jul 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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 A15824 NC Primary

Addresses

Primary practice location

12 Juniper TRL Ste 201
Southern Shores, NC 27949-3750

Mailing address

12 Juniper TRL Ste 201
Southern Shores, NC 27949-3750
Phone (252) 512-4245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20240105003300 NC Practitioner - Mental Health Counselor 7517318355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holland and Associates Counseling PLLCGroup PAC ID 5395194724, 6 clinicians

Practice addresses (Care Compare)

2224 S Croatan Hwy
D7 PMB 21
Nags Head, NC 27959
Phone (252) 255-2733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A15824NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Holland and Associates Counseling, PLLC. CurrentSince Jan 1, 2024 Accepting new patients

Locations

7467 Caratoke Hwy
Ste 1
Jarvisburg, NC 27947
Phone (252) 255-2733

2224 S Croatan Hwy
#D7
Nags Head, NC 27959
Phone (252) 255-2733

2224 S Croatan Hwy
Ste 21
Nags Head, NC 27959

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

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1366060402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 JUNIPER TRL STE 201",
            "city": "SOUTHERN SHORES",
            "state": "NC",
            "postal_code": "279493750",
            "telephone_number": "252-512-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 JUNIPER TRL STE 201",
            "city": "SOUTHERN SHORES",
            "state": "NC",
            "postal_code": "279493750",
            "telephone_number": "252-512-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "MARIE",
        "middle_name": "LUISE",
        "credential": "LCMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A15824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southern Shores, NC

Sources for this page

Verify at the official NPI Registry.