Provider Demographics
NPI:1093424277
Name:SHELBY, MELINDA DARLENE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:DARLENE
Last Name:SHELBY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 TURKEY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MO
Mailing Address - Zip Code:63379-4166
Mailing Address - Country:US
Mailing Address - Phone:636-338-9908
Mailing Address - Fax:
Practice Address - Street 1:6055 MEXICO RD
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1632
Practice Address - Country:US
Practice Address - Phone:636-294-2694
Practice Address - Fax:636-222-9277
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022040480101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health