Individual provider Active NPI

Mary Kay Shelton

  • Mental Health Counselor
  • Cleveland, OH
National Provider Identifier
1629648407
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
16600 W Sprague Rd
Cleveland, OH 44130-6318
Phone
(440) 523-0370
NPI assigned
Jun 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Counselor 101Y00000X

Addresses

Primary practice location

16600 W Sprague Rd
Cleveland, OH 44130-6318

Mailing address

1578 Hopkins Ave
Lakewood, OH 44107-5037
Phone (440) 708-8922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241118000255 OH Practitioner - Mental Health Counselor 2163956897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integration CounselingGroup PAC ID 8921532664, 3 clinicians

Practice addresses (Care Compare)

14701 Detroit Ave
Suite 587
Lakewood, OH 44107-4115
Phone (440) 708-8922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integration Counseling Mental Health CurrentSince Jul 12, 2024 Accepting new patients

Locations

14701 Detroit Ave
Ste 587
Lakewood, OH 44107
Phone (440) 708-8922

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.

NPI Registry JSON

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1629648407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1578 HOPKINS AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441075037",
            "telephone_number": "440-708-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16600 W SPRAGUE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441306318",
            "telephone_number": "440-523-0370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "MARY KAY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-25",
        "last_updated": "2021-06-25",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.