Shelby Diane Smith

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

132240 Issued in CA

Practice address

1314 Oregon St
Redding, CA 96001-1621

Phone

(530) 351-5215

NPI assigned

Aug 28, 2017

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

Other names 1

• Shelby Diane Green Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2024 through Oct 1, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1503878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1659898948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 CHURN CREEK RD",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960022513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 OREGON ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011621",
            "telephone_number": "530-351-5215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 Churn Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Redding",
            "state": "CA",
            "postal_code": "960022513",
            "country_code": "US",
            "telephone_number": "530-223-2822",
            "fax_number": "530-223-1917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "SHELBY",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-28",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "132240",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MARRIAGE AND FAMILY THERAPIST",
            "identifier": "1659898948",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "GREEN",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leyla Smith, MFT
• Liberty Faith Smith
• Mike Smith
• Robert Joseph Smith, D.C.
• Roger Ward Smith, PTA
• Susan Herriott Smith, C.M.T.
• Toby Eugene Smith
• William Brian Snider, CP
• William Joseph Snider, M.D.
• Savannah Snook, PA-C

• Mental Health Counselor in Redding, CA
• Providers in Redding, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.