Active NPI
Thomas Joe Shelder, LMFT
- Marriage & Family Therapist
- Traverse City, MI
National Provider Identifier
1881717536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 4101006257
- Practice address
- 902 W Front St
Traverse City, MI 49684-2328 - Phone
- (231) 645-3735
- Fax
- (231) 276-9152
- NPI assigned
- Apr 9, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 4101006257 | MI | Primary |
Addresses
Primary practice location
902 W Front St
Traverse City, MI 49684-2328
Mailing address
4833 Moulton Rd
Grawn, MI 49637-9737
Phone (231) 645-3735
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 |
|---|---|---|---|
| 4101006257 | MI | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1881717536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4833 MOULTON RD",
"city": "GRAWN",
"state": "MI",
"postal_code": "496379737",
"telephone_number": "231-645-3735",
"fax_number": "231-276-9152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "902 W FRONT ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842328",
"telephone_number": "231-645-3735",
"fax_number": "231-276-9152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELDER",
"first_name": "THOMAS",
"middle_name": "JOE",
"name_prefix": "Mr.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MI",
"license": "4101006257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.