Shelby Lyne Clarke, M.A

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2855 E Hayes St Ste 201
Newberg, OR 97132-1390

Phone

(503) 395-7109

NPI assigned

May 19, 2022

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

Credentials

Master of Arts

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.

• Second Growth Counseling LLC

  dba Second Growth Counseling

  • Professional Counselor
  • Portland, OR
  • NPI 1871083691
  NPD

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1770220725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 SW 184TH TER",
            "city": "ALOHA",
            "state": "OR",
            "postal_code": "970033869",
            "telephone_number": "503-713-3154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 E HAYES ST STE 201",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321390",
            "telephone_number": "503-395-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "SHELBY",
        "middle_name": "LYNE",
        "credential": "M.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-19",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Choi, PHARMD
• Spencer James Chun, MD
• Anne C Church, MA,LPC,CADC II
• City of Newberg
• Yanyan Claflin
• David Clemans, RNFA
• Clover Clinic Community Services (The Clover Clinic)
• Jamie Cobb, CRNA
• John J. Collins, DC
• Columbia Cardiology Associates LTD

• Mental Health Counselor in Newberg, OR
• Providers in Newberg, 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 May 19, 2022; 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.