Shelby Elise Pearson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

21-QMHP-R-0789 Issued in OR

Practice address

33 NW Broadway
Portland, OR 97209-3580

Phone

(458) 253-9898

NPI assigned

May 6, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Pacific University

  • Adult Mental Health Clinic/Center
  • Hillsboro, OR
  • NPI 1700256989
  NPD (past)

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1700441755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 SE 8TH AVE STE 212",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 NW BROADWAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093580",
            "telephone_number": "458-253-9898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 SE 8th Ave Ste 212",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971234218",
            "country_code": "US",
            "telephone_number": "503-352-7333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "SHELBY",
        "middle_name": "ELISE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "21-QMHP-R-0789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Louise Pearson, OTR
• Laurie Y. Pearson, LCSW
• Linda Pearson
• Nancy Anne Pearson, LCSW
• Phoebe Pearson, PT, DPT
• Sonja Pearson, LMT
• Theodore Lee Pearson III, CADC I
• Tuesday Elizabeth Pearson, D.O.
• Susan Pease Banitt, LCSW
• Letha Pease, LMT

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.