Provider Demographics
NPI:1386035541
Name:HOLYBEE, SHELLY NICOLE (MA LMFT)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:NICOLE
Last Name:HOLYBEE
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:SHELLY
Other - Middle Name:NICOLE
Other - Last Name:BAROLDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAMFTI
Mailing Address - Street 1:8176 COUNTRY MILE LN
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-0029
Mailing Address - Country:US
Mailing Address - Phone:909-529-0849
Mailing Address - Fax:
Practice Address - Street 1:219 N INDIAN HILL BLVD STE 102
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4644
Practice Address - Country:US
Practice Address - Phone:909-529-0849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-10
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF82864106H00000X
CALMFT107981106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist