Shelley Lynn Shields

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMF90778 Issued in CA

Practice address

1129 Marsh St
San Luis Obispo, CA 93401-3323

Phone

(805) 543-7969

Fax

(805) 543-0859

NPI assigned

Jan 13, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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.

• Community Counseling Center

  • Community/Behavioral Health Agency
  • San Luis Obispo, CA
  • NPI 1730633207
  NPD (past)

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1740646264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 MARSH ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013323",
            "telephone_number": "805-543-7969",
            "fax_number": "805-543-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 MARSH ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013323",
            "telephone_number": "805-543-7969",
            "fax_number": "805-543-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "SHELLEY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF90778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry James Sherfield, LCSW
• Charlene A Sheridan, N.P.
• Mark D Sherman, MD
• Cynthia Shibutani
• Madison Shields
• Kara Anne Prinz Shipcott, MA
• Kristina J Shippey
• Cheryl Shivaprasad, PPS
• Carolyn NMN Shively
• Alexis Henley Shohet

• Mental Health Counselor in San Luis Obispo, CA
• Providers in San Luis Obispo, 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 13, 2016; 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.