Individual provider Active NPI

Shelly Smith Cavin, LPC

  • Counselor
  • Fort Worth, TX
National Provider Identifier
1639446776
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
13895 Issued in TX
Practice address
7451 Aspen Wood CT
Fort Worth, TX 76179-2909
Phone
(817) 999-5335
NPI assigned
Nov 17, 2011
Last updated
Nov 17, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 13895 TX Primary

Addresses

Primary practice location

7451 Aspen Wood CT
Fort Worth, TX 76179-2909

Mailing address

7451 Aspen Wood CT
Fort Worth, TX 76179-2909
Phone (817) 999-5335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240412000419 TX Practitioner - Mental Health Counselor 2567801442 Practice locations: McKinney, TX

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1833 W Hunt St
McKinney, TX 75069-3367
Phone (817) 999-5335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13895TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1639446776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7451 ASPEN WOOD CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761792909",
            "telephone_number": "817-999-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7451 ASPEN WOOD CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761792909",
            "telephone_number": "817-999-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVIN",
        "first_name": "SHELLY",
        "middle_name": "SMITH",
        "name_prefix": "Dr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-17",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "13895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.