Fentress, Shelley M

Fentress, Shelley M is an individual health care provider with primary practice located at 107 Cranes Roost Ct , Elizabethtown KY 42701-3650. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Fentress, Shelley M can be contacted via phone (270) 765-2605.

Contact Information

Primary practice address
107 Cranes Roost Ct Elizabethtown KY 42701-3650
Phone: (270) 765-2605
Fax: (270) 234-8572
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X KY-0412 Kentucky

Profile Details

NPI number 1508902628
LBN Legal business name Fentress, Shelley M
Credentials LPCC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 29th, 2007
Last updated Nov 22nd, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508902628 NPPES
Kentucky Other 000000530500 ANTHEM
Kentucky MEDICAID 30605018 ANTHEM

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