Schellie Michelle Fanfan, LMHC, MS, EDS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH8246 Issued in FL

Practice address

1617 E Vine St
Kissimmee, FL 34744-3740

Phone

(407) 235-8151

Fax

(407) 452-3474

NPI assigned

Jun 9, 2009

Last updated

Jun 9, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mrs. Schellie Michelle Fanfan-Sissoko Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ask Schellie Consulting, LLC

  • Mental Health Counselor
  • Orlando, FL
  • NPI 1568069540
  NPD Authorized official
• Harmony Mental Health and Behavioral Services, LLC

  • Community/Behavioral Health Agency
  • Orlando, FL
  • NPI 1295965234
  NPD (past)

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244505600000",
    "number": "1972739589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 585509",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328585509",
            "telephone_number": "407-235-8151",
            "fax_number": "407-452-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 E VINE ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347443740",
            "telephone_number": "407-235-8151",
            "fax_number": "407-452-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANFAN",
        "first_name": "SCHELLIE",
        "middle_name": "MICHELLE",
        "credential": "LMHC, MS, EDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-09",
        "last_updated": "2009-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WAIVER",
            "identifier": "691610498",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WAIVER",
            "identifier": "691610496",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SCHELLIE",
            "last_name": "FANFAN-SISSOKO",
            "middle_name": "MICHELLE",
            "prefix": "MRS.",
            "credential": "LMHC, MS, EDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Family Life Services Ministries & TCM, Inc.
• Family Medical Clinic, LLC
• Family Medicine at Kissimmee, LLC
• Family Members Behavioral Services, Inc.
• Family Tree Medical Group, PA
• Eleyn Fangonilo
• George Farag, RPH
• Stuart R Farber, MD
• Maria I Farfan
• Crystien Daniel Faria

• Mental Health Counselor in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; 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.