Kelly Marie Shane, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0162101 Issued in NM

Practice address

8416 Sonoma Valley Rd NE
Albuquerque, NM 87122-2626

Phone

(505) 459-4647

NPI assigned

Jul 28, 2008

Last updated

Sep 2, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sandia Counseling Center LLC

  • Mental Health Counselor
  • Albuquerque, NM
  • NPI 1568946358
  NPD (past) Authorized official

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1750546990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8416 SONOMA VALLEY RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87122",
            "telephone_number": "505-459-4647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8416 SONOMA VALLEY RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871222626",
            "telephone_number": "505-459-4647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANE",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0162101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamarie Sais, MD, PC
• Ayanna Shambe, MD
• Rachael Shams-Avari, RPH
• Emily Shanahan
• Caitlin Shane
• Lauren Shaner
• Daniel J. Shank, M.D.
• Rhonda Ashley Shankles, LPN
• Jessica Shanklin
• Elizabeth Shanley, PA

• Mental Health Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.