Shelby Boom, LLMSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6851121040 Issued in MI

Practice address

29877 Telegraph Rd Ste 400
Southfield, MI 48034-7661

Phone

(248) 294-0539

NPI assigned

Dec 9, 2025

Last updated

Dec 9, 2025By the provider in NPPES

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

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": "1765238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1639032345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29877 TELEGRAPH RD STE 400",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29877 TELEGRAPH RD STE 400",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347661",
            "telephone_number": "248-294-0539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOM",
        "first_name": "SHELBY",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-09",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6851121040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Susie Bonner, RN
• Peter Louis Bono, DO
• Simina Bono, DPT
• Charisse Celeste Booker-Allen
• Stephanie Booker
• Tabbitha Boonstra
• Amanda M Booth
• Shastri Boothe, PA
• Julie M Borkin
• Alana Borkowski

• Mental Health Counselor in Southfield, MI
• Providers in Southfield, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; 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.