Shields Therapy LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P0501003 Issued in AR

Legal business name

SHIELDS THERAPY LLC

Practice address

1 W Sunbridge Dr
Fayetteville, AR 72703-1825

Phone

(479) 443-5575

Fax

(479) 443-9554

NPI assigned

Dec 20, 2013

Organization subpart

No

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

Authorized official

Name

Charles Shields, LPC

Title

Sole Member

Phone

(479) 443-5575

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387497600000",
    "number": "1790106508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W SUNBRIDGE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031825",
            "telephone_number": "479-443-5575",
            "fax_number": "479-443-9554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W SUNBRIDGE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031825",
            "telephone_number": "479-443-5575",
            "fax_number": "479-443-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIELDS THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-20",
        "last_updated": "2013-12-20",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "479-443-5575",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P0501003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Shepherd
• Scott Shepherd, CRNA
• Carissa Lee Sherwood, DMD
• Janie Linda Sherwood, CRNA
• Patrick W Shewmaker
• Abbey Breanna Shields, APRN
• Xochitl Shields
• Audrey Claire Shilander, D.O.
• Shiloh Health and Longevity
• Holly Shinn, RN/MHPP

• Professional Counselor in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.