Shell Christine, LCPC CRADC NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180006736 Issued in IL

Practice address

1414 Main St
Melrose Park, IL 60160-3902

Phone

(708) 786-8541

Fax

(708) 681-3958

NPI assigned

Jan 23, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: shell.christine.1@21300.direct.athenahealth.com

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.

• Presence Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Westchester, IL
  • NPI 1356597314
  NPD (past)

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324425600000",
    "number": "1427235274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8212 ANCHOR DRIVE",
            "address_2": "#501",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "60517",
            "telephone_number": "708-308-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 MAIN ST",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601603902",
            "telephone_number": "708-786-8541",
            "fax_number": "708-681-3958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTINE",
        "first_name": "SHELL",
        "name_prefix": "Ms.",
        "credential": "LCPC CRADC NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-23",
        "last_updated": "2011-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "13056",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "75018",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180006736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lily Cherny, CRNA
• Chiropractic Connection LTD
• Iffat A Choudhry, M.D.
• Clark D Chrisman, RPH
• Andrew M Christ, CRNA
• Manas Chug, D.D.S
• Sinha S Chunduri, M.D.
• Cimpar Clinical Laboratories, LLC
• Cimpar Pharmacy LLC
• Sheilah Bridget Cintron, M.D.

• Professional Counselor in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.