Shelley L Dejongh, MS, LPC, CSAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4160-125 Issued in WI

Practice address

2925 Mondovi Rd
Eau Claire, WI 54701-6141

Phone

(715) 832-0238

Fax

(715) 832-0771

NPI assigned

Dec 19, 2006

Last updated

May 11, 2011By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: shelleydejongh@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Professional

  NPD

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305072000000",
    "number": "1639232655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 MONDOVI RD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016141",
            "telephone_number": "715-832-0238",
            "fax_number": "715-832-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 MONDOVI RD",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016141",
            "telephone_number": "715-832-0238",
            "fax_number": "715-832-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJONGH",
        "first_name": "SHELLEY",
        "middle_name": "L",
        "credential": "MS, LPC, CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2011-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4160-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39170000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Decker, DPT
• Lauren Deery
• Mackenzie Ann Deffenbaugh, LPC
• Krysti M Deines, LPC, SAC-IT
• Wendy C Deiss, LPN
• John N Delakis, OPTICIAN
• Paul J Delakis, OD
• Paul S Delakis, O.D.
• Christine Delanghe
• Rachel Delanois

• Professional Counselor in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; 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.