Individual provider Active NPI

Shawna Kelly

  • Mental Health Counselor
  • Upper Saint Clair, PA
National Provider Identifier
1790240505
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC011130 Issued in PA
Practice address
1580 McLaughlin Run Rd Ste 105
Upper Saint Clair, PA 15241-3100
Phone
(412) 841-1163
NPI assigned
Feb 6, 2019
Last updated
Oct 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC011130 PA Primary

Addresses

Primary practice location

1580 McLaughlin Run Rd Ste 105
Upper Saint Clair, PA 15241-3100

Mailing address

11279 Perry Hwy
Wexford, PA 15090-9381

Other practice location 1

11279 Perry Hwy
Wexford, PA 15090-9381
Phone (724) 933-1020

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address CHP@upmcdirect.com UPMC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PC011130PAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1790240505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11279 PERRY HWY",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 MCLAUGHLIN RUN RD STE 105",
            "city": "UPPER SAINT CLAIR",
            "state": "PA",
            "postal_code": "152413100",
            "telephone_number": "412-841-1163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11279 Perry Hwy",
            "address_purpose": "LOCATION",
            "city": "Wexford",
            "state": "PA",
            "postal_code": "150909381",
            "country_code": "US",
            "telephone_number": "724-933-1020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SHAWNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-06",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC011130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CHP@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Upper Saint Clair, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.