Organization Active NPI

Therapy Services With Shelley, PLLC

  • Community/Behavioral Health Agency
  • Moorhead, MN
National Provider Identifier
1659806495
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1264 Issued in MN
Legal business name
THERAPY SERVICES WITH SHELLEY, PLLC
Practice address
820 4TH St S
Moorhead, MN 56560-3322
Phone
(218) 329-6294
NPI assigned
May 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Authorized official

Name
Michelle Dahl Monroe, LMFT
Title
Owner/Therapist
Phone
(218) 329-6294

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 2009-027 ND
Community/Behavioral Health Agency 251S00000X 1264 MN Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

820 4TH St S
Moorhead, MN 56560-3322

Mailing address

820 4TH St S
Moorhead, MN 56560-3322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191112001400 MN Part B Supplier - Clinic/Group Practice 5294067104 Receives reassigned benefits from 1 practitioner
Practice locations: Moorhead, MN

National Provider Directory

National Provider Directory

Locations

2419 12th Ave S
Ste 2C
Moorhead, MN 56560

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703548800000",
    "number": "1659806495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 4TH ST S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565603322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 4TH ST S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565603322",
            "telephone_number": "218-329-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPY SERVICES WITH SHELLEY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-01",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A",
        "authorized_official_last_name": "DAHL MONROE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "218-329-6294",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ND",
            "license": "2009-027",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "1264",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.