Shelby L. Kandziora, LPC-IT, SAC-IT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3468-226 Issued in WI

Practice address

903 Mineral Point Ave
Janesville, WI 53548-2970

Phone

(608) 756-6530

Fax

(608) 741-6918

NPI assigned

Apr 27, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shelby L. Meyer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1972038958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482970",
            "telephone_number": "608-756-6530",
            "fax_number": "608-741-6918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482970",
            "telephone_number": "608-756-6530",
            "fax_number": "608-741-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDZIORA",
        "first_name": "SHELBY",
        "middle_name": "L.",
        "credential": "LPC-IT, SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-27",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "18012-130",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3468-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "MEYER",
            "middle_name": "L.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katheryn R Kaldor, DO
• Jayne Kalemba, LPN
• Robert L Kalember, MD
• Richard J Kallio, R.PH.
• Lubin Kan, MD, PHD
• Kendra Karbouski, LCSW
• Patricia E. Karras, PTA
• Mark Allen Karrels, DDS
• Benjamin H Kartman, MD
• Sara A Kaster, APRN, FNP

• Professional Counselor in Janesville, WI
• Providers in Janesville, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2017; 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.