Individual provider Active NPI

Marya Christine Ford Shields, PLPC

  • Mental Health Counselor
  • Slidell, LA
National Provider Identifier
1497366785
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
310 Kensington Blvd
Slidell, LA 70458-2248
Phone
(985) 262-2240
NPI assigned
Aug 11, 2020
Last updated
Aug 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

310 Kensington Blvd
Slidell, LA 70458-2248

Mailing address

310 Kensington Blvd
Slidell, LA 70458-2248
Phone (985) 262-2240

Other practice location 1

3525 Hessmer Ave Ste 308
Metairie, LA 70002-6407
Phone (504) 457-2223

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chris@counselingslidell.com Direct

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Counseling Center at Northshore Church Mental Health CurrentSince Aug 23, 2020 Accepting new patients

Locations

310 Kensington Blvd
Slidell, LA 70458
Phone (985) 262-1220

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": "1597104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1497366785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 KENSINGTON BLVD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582248",
            "telephone_number": "985-262-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 KENSINGTON BLVD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582248",
            "telephone_number": "985-262-2240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3525 Hessmer Ave Ste 308",
            "address_purpose": "LOCATION",
            "city": "Metairie",
            "state": "LA",
            "postal_code": "700026407",
            "country_code": "US",
            "telephone_number": "504-457-2223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "MARYA CHRISTINE",
        "middle_name": "FORD",
        "credential": "PLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chris@counselingslidell.com",
            "affiliation": "N",
            "endpointDescription": "Professional email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "310 Kensington Blvd",
            "city": "Slidell",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704582248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.