Shelly Donoghue

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

3830 S Cushman St
Fairbanks, AK 99701-7530

Phone

(907) 455-1467

NPI assigned

Aug 6, 2007

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 9, 2012.

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1508057449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 S CUSHMAN ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017530",
            "telephone_number": "907-455-1467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 S CUSHMAN ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017530",
            "telephone_number": "907-455-1467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOGHUE",
        "first_name": "SHELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MH0157",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stefanie Lyn Donahue
• Carly Donald
• Lisa Jean Donat, RN
• Kaitln Donnelly
• Susana Donofry, DNP
• Valerie Renee Dorsch
• Monique Dorsey
• Robert Richard Dorton, COUNSELOR TECHNICIAN
• Virginia Paige Dougherty, MS, RD, LDN
• Herrell Addison Douglas Jr.

• All providers in Fairbanks, AK
• Mental Health Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; 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.