Active NPI
Shelby Marie Colbert
- Marriage & Family Therapist
- San Bernardino, CA
National Provider Identifier
1598187155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 111860
- Practice address
- 237 W Mill St
San Bernardino, CA 92408-1403 - Phone
- (909) 418-5612
- NPI assigned
- Jan 15, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 78763 | CA | |
| Marriage & Family Therapist | 106H00000X | 111860 | CA | Primary |
Addresses
Primary practice location
237 W Mill St
San Bernardino, CA 92408-1403
Mailing address
237 E Mill Street
San Bernandio, CA 92407
Phone (909) 388-5600
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111860 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of San Bernardino | Past | Accepting new patients |
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 and National Provider Directory roles.
-
dba Supportive Services
- Adult Mental Health Clinic/Center
- San Bernardino, CA
- NPI 1306055603
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550707200000",
"number": "1598187155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "237 E MILL STREET",
"city": "SAN BERNANDIO",
"state": "CA",
"postal_code": "92407",
"telephone_number": "909-388-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "237 W MILL ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924081403",
"telephone_number": "909-418-5612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLBERT",
"first_name": "SHELBY",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-15",
"last_updated": "2019-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "78763",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "111860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.