Shelle Mathis, L.P.C.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C 0600302 Issued in OH

Practice address

611 Garfield Ave
Elyria, OH 44035-3403

Phone

(440) 322-7551

Fax

(440) 322-7551

NPI assigned

Mar 8, 2010

Last updated

May 28, 2020By the provider in NPPES

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

Other identifiers 1

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.

• Shelle M Mathis Counseling Services LLC

  • Mental Health Counselor
  • Elyria, OH
  • NPI 1932068400
  NPD Authorized official

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1801119789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 GARFIELD AVE",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440353403",
            "telephone_number": "440-322-7551",
            "fax_number": "440-322-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 GARFIELD AVE",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440353403",
            "telephone_number": "440-322-7551",
            "fax_number": "440-322-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "SHELLE",
        "credential": "L.P.C.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-08",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C 0600302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0303506",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colleen F Martin-Telfer, LSW
• Alisa Marvin, PA-C
• Mary Elaine Krosse, DPM
• Ramiz Masri, M.D.
• Michael Mastrangelo
• Matthias Helfrich O.D. Inc
• Michelle Marie Mattingly
• James Maxwell, LSW
• Kathleen Mayer
• Carmita Mayfield, LPN

• Professional Counselor in Elyria, OH
• Providers in Elyria, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; 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.