Jennifer Lynn Shirley, LMHC, LPC, CRC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MHC01054 Issued in RI

Practice address

569 Main St
Warren, RI 02885-4356

Phone

(401) 903-0324

NPI assigned

May 24, 2016

Last updated

Apr 10, 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 3

Addresses

Other names 1

• Ms. Jennifer Lynn Anderson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Shirley LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hebron, CT
  • NPI 1659166825
  NPD Authorized official

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1467809053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HEARTHSTONE DR",
            "city": "HEBRON",
            "state": "CT",
            "postal_code": "062481202",
            "telephone_number": "401-903-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "569 MAIN ST",
            "city": "WARREN",
            "state": "RI",
            "postal_code": "028854356",
            "telephone_number": "401-903-0324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Hearthstone Dr",
            "address_purpose": "LOCATION",
            "city": "Hebron",
            "state": "CT",
            "postal_code": "062481202",
            "country_code": "US",
            "telephone_number": "401-903-0324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMHC, LPC, CRC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "MHC01054",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "006960",
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "NU",
            "license": "00233417",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "ANDERSON",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "LMHC, CRC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Warren, RI
• Providers in Warren, RI by specialty
• Mental Health Counselor in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.