Provider Demographics
NPI:1053072520
Name:GABBARD, SHELBI RAELYNNE (LMHCA, ATR-P)
Entity Type:Individual
Prefix:
First Name:SHELBI
Middle Name:RAELYNNE
Last Name:GABBARD
Suffix:
Gender:F
Credentials:LMHCA, ATR-P
Other - Prefix:
Other - First Name:SHELBI
Other - Middle Name:RAELYNNE
Other - Last Name:TIDD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10480 GREENWAY DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9368
Mailing Address - Country:US
Mailing Address - Phone:317-457-5274
Mailing Address - Fax:
Practice Address - Street 1:939-B CONNOR STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060
Practice Address - Country:US
Practice Address - Phone:317-643-0586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN88001233A101YM0800X
IN221700000X
IN39004402A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist