Mary E Shockley, MED LMHC MHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60855866 Issued in WA

Practice address

12533 Reiner Rd
Monroe, WA 98272

Phone

(425) 770-1117

NPI assigned

Mar 7, 2013

Last updated

May 24, 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

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590278400000",
    "number": "1891036315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12533 REINER RD",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982729553",
            "telephone_number": "425-770-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12533 REINER RD",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "98272",
            "telephone_number": "425-770-1117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14655 NE Bel Red Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980073900",
            "country_code": "US",
            "telephone_number": "425-200-4611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOCKLEY",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "MED LMHC MHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-07",
        "last_updated": "2020-05-24",
        "certification_date": "2020-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60855866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2111780",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Monroe, WA
• Providers in Monroe, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.