Active NPI
Huntly Elberto Shelton III, PH.D.
- Psychologist
- Fort Worth, TX
National Provider Identifier
1922343920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 12050
- Practice address
- 3840 Hulen St
Suite 105
Fort Worth, TX 76107-7277 - Phone
- (817) 732-8561
- Fax
- (817) 732-8561
- NPI assigned
- Dec 1, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 4154 | TX | |
| Psychologist | 103T00000X | 12050 | TX | Primary |
Addresses
Primary practice location
3840 Hulen St
Suite 105
Fort Worth, TX 76107-7277
Mailing address
3840 Hulen St
Suite 105
Fort Worth, TX 76107-7277
Phone (817) 732-8561
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4154 | TX | MD | Counselor |
| 12050 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354320000000",
"number": "1922343920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3840 HULEN ST",
"address_2": "SUITE 105",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761077277",
"telephone_number": "817-732-8561",
"fax_number": "817-732-8561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3840 HULEN ST",
"address_2": "SUITE 105",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761077277",
"telephone_number": "817-732-8561",
"fax_number": "817-732-8561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHELTON",
"first_name": "HUNTLY",
"middle_name": "ELBERTO",
"name_suffix": "III",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-12-01",
"last_updated": "2012-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "4154",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "12050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.