Shelly Marie Osborne, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC-5757 Issued in ID

Practice address

112 Shoshone St E Ste 2
Twin Falls, ID 83301-6185

Phone

(208) 860-8203

NPI assigned

May 7, 2019

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 names 1

• Shelly Marie Lewis Former name

Electronic endpoints 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 and National Provider Directory roles.

• Altis Counseling Associates, LLC

  • Professional Counselor
  • Twin Falls, ID
  • NPI 1710541719
  NPD (past) Authorized official

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1841855798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 POLE LINE RD",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014083",
            "telephone_number": "208-860-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 SHOSHONE ST E STE 2",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016185",
            "telephone_number": "208-860-8203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "SHELLY",
        "middle_name": "MARIE",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-5757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shelly@altiscounseling.com",
            "affiliation": "N",
            "endpointDescription": "ALTIS",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "112 Shoshone St E Ste 2",
            "city": "Twin Falls",
            "state": "ID",
            "country_code": "US",
            "postal_code": "833016185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHELLY",
            "last_name": "LEWIS",
            "middle_name": "MARIE",
            "credential": "LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sonya Sue Orr, NP
• Jessica Orsland
• Jesus Ortega, CADC
• Orthopro of Twin Falls, Inc
• Adan Ortiz, PHARMD
• Melissa Dawn Osen, LCSW
• Shane Michael Osgood, ATC, CEAS
• Joseph Eldon Ostler, M.D., PH.D.
• Paul G. Ostyn, MPT, MA
• Amanda Lynn Overacre, LCSW

• Mental Health Counselor in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.