Active NPI
Robin Shell, LCPC
- Professional Counselor
- Glenn Dale, MD
National Provider Identifier
1861083107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC5186
- Practice address
- 11412 Kedleston Rd
Glenn Dale, MD 20769-2019 - Phone
- (240) 472-9919
- NPI assigned
- Jan 29, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC5186 | MD | Primary |
Addresses
Primary practice location
11412 Kedleston Rd
Glenn Dale, MD 20769-2019
Mailing address
11412 Kedleston Rd
Glenn Dale, MD 20769-2019
Phone (240) 472-9919
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
| License | State | Type | Specialty |
|---|---|---|---|
| LC5186 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611878400000",
"number": "1861083107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11412 KEDLESTON RD",
"city": "GLENN DALE",
"state": "MD",
"postal_code": "207692019",
"telephone_number": "240-472-9919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11412 KEDLESTON RD",
"city": "GLENN DALE",
"state": "MD",
"postal_code": "207692019",
"telephone_number": "240-472-9919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELL",
"first_name": "ROBIN",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-29",
"last_updated": "2021-01-29",
"certification_date": "2021-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC5186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenn Dale, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.