Provider Demographics
NPI:1417228545
Name:ALBAUGH, SHELLANE LARUE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:SHELLANE
Middle Name:LARUE
Last Name:ALBAUGH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 S HIGH AVE
Mailing Address - Street 2:AMES
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-8055
Mailing Address - Country:US
Mailing Address - Phone:515-232-3206
Mailing Address - Fax:515-232-3780
Practice Address - Street 1:1619 S HIGH AVE
Practice Address - Street 2:AMES
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8055
Practice Address - Country:US
Practice Address - Phone:515-232-3206
Practice Address - Fax:515-232-3780
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health