Active NPI
Shelley Kay Gore Elliott, MS, LPC
- Counselor
- Southlake, TX
National Provider Identifier
1548480494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 60776
- Practice address
- 211 E Southlake Blvd
Suite 115
Southlake, TX 76092-6265 - Phone
- (817) 917-6088
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 60776 | TX | Primary |
Addresses
Primary practice location
211 E Southlake Blvd
Suite 115
Southlake, TX 76092-6265
Mailing address
211 E Southlake Blvd
Suite 115
Southlake, TX 76092-6265
Phone (817) 917-6088
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60776 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548480494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 E SOUTHLAKE BLVD",
"address_2": "SUITE 115",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926265",
"telephone_number": "817-917-6088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 E SOUTHLAKE BLVD",
"address_2": "SUITE 115",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760926265",
"telephone_number": "817-917-6088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "SHELLEY",
"middle_name": "KAY GORE",
"credential": "MS, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "60776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.