Individual provider Active NPI

Shelley Deibel, LPCC

  • Professional Counselor
  • Elizabethtown, KY
National Provider Identifier
1962456004
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
105656 Issued in KY
Practice address
1106 Tunnel Hill Road
Suite 100
Elizabethtown, KY 42701-1837
Phone
(270) 765-2335
Fax
(270) 765-2557
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 105656 KY Primary

Addresses

Primary practice location

1106 Tunnel Hill Road
Suite 100
Elizabethtown, KY 42701-1837

Mailing address

1106 Tunnel Hill Road
Suite 100
Elizabethtown, KY 42701-1837
Phone (270) 765-2335

Other identifiers 2

IdentifierTypeStateIssuer
11574911OtherCAQH
7100265840MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241217002090 KY Practitioner - Mental Health Counselor 6507393444 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Next Step Counseling Services, LLC Professional CurrentSince Dec 19, 2023 Accepting new patients

Locations

1106 Tunnel Hill Rd
Ste 100
Elizabethtown, KY 42701
Phone (270) 675-2335

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1962456004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 TUNNEL HILL ROAD",
            "address_2": "SUITE 100",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011837",
            "telephone_number": "270-765-2335",
            "fax_number": "270-765-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 TUNNEL HILL ROAD",
            "address_2": "SUITE 100",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011837",
            "telephone_number": "270-765-2335",
            "fax_number": "270-765-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEIBEL",
        "first_name": "SHELLEY",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "105656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11574911",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100265840",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.