Elizabeth Burty Shadden, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH789 Issued in FL

Practice address

655 W 8TH St
Ufjp Psychiatric
Jacksonville, FL 32209-6511

Phone

(904) 244-3688

Fax

(904) 244-3455

NPI assigned

May 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Martha Elizabeth Burty Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429660800000",
    "number": "1518910116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-3199",
            "fax_number": "904-244-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "address_2": "UFJP PSYCHIATRIC",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-3688",
            "fax_number": "904-244-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADDEN",
        "first_name": "ELIZABETH",
        "middle_name": "BURTY",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2015-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTHA",
            "last_name": "BURTY",
            "middle_name": "ELIZABETH",
            "prefix": "MS.",
            "credential": "LMHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Eva Shabo, OD
• Robert Shackelford
• Brittni Shackleford
• Lori Shad
• Rachael Morrow Shad, APRN
• Paige Shadden
• Shades of Autism Parent Network, Inc.
• Michael Shaeffer, DMD
• Warren Shaeffer
• Willette Shaeffer, DMD

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.