Patrick Michael Shively, AMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT127155 Issued in CA

Practice address

3451 W Shaw Ave
Fresno, CA 93711-3242

Phone

(559) 492-8327

NPI assigned

Apr 11, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Michael Shively Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Omid Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • Fresno, CA
  • NPI 1982374799
  NPD
• Hope Horizon Mental Health

  • Community/Behavioral Health Agency
  • Tulare, CA
  • NPI 1881719839
  NPD (past)

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1912692229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 S K ST",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932745416",
            "telephone_number": "559-688-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 W SHAW AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937113242",
            "telephone_number": "559-492-8327"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "327 S K St",
            "address_purpose": "LOCATION",
            "city": "Tulare",
            "state": "CA",
            "postal_code": "932745416",
            "country_code": "US",
            "telephone_number": "559-688-2043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIVELY",
        "first_name": "PATRICK",
        "middle_name": "MICHAEL",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT127155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "SHIVELY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Teddie Shirley
• Shiro Ego, DDS, Inc.
• Matthew Shirts, CRNA
• Oganes Shishikyan
• Anand Neil Shivaprasad, DO
• Betsy Joy Shivers, M.A.,ATC
• Nicole Ann Shlimun, D.O.
• Julia Shmorgun, O.D.
• Adrianna Louise Shoji, PH.D.
• Zahra Shokri Varniab

• Marriage & Family Therapist in Fresno, CA
• Providers in Fresno, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.