Individual provider Active NPI

Shelley J. Pasma, M.A., L.C.P.C.

  • Professional Counselor
  • Libertyville, IL
National Provider Identifier
1942345335
Registry record updated Mar 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180001462 Issued in IL
Practice address
800 S Milwaukee Ave
Suite 105
Libertyville, IL 60048-3254
Phone
(847) 362-1224
Fax
(847) 918-1033
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2015

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3948125 WI
Addiction (Substance Use Disorder) Counselor 101YA0400X 394825 WI
Mental Health Counselor 101YM0800X 3948125 WI
Mental Health Counselor 101YM0800X 180001462 IL
Professional Counselor 101YP2500X 180001462 IL Primary

Addresses

Primary practice location

800 S Milwaukee Ave
Suite 105
Libertyville, IL 60048-3254

Mailing address

31162 N. Bob-O-Link Lane
Libertyville, IL 60048
Phone (847) 362-1224

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
394825WIMDAddiction (Substance Use Disorder) Counselor
180001462ILMDProfessional Counselor
3948125WIMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425168000000",
    "number": "1942345335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31162 N. BOB-O-LINK LANE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "60048",
            "telephone_number": "847-362-1224",
            "fax_number": "847-918-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S MILWAUKEE AVE",
            "address_2": "SUITE 105",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483254",
            "telephone_number": "847-362-1224",
            "fax_number": "847-918-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASMA",
        "first_name": "SHELLEY",
        "middle_name": "J.",
        "credential": "M.A.,  L.C.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2015-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3948125",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "394825",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3948125",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180001462",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180001462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2015; 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.