Provider Demographics
NPI:1497901060
Name:MAY, SHELLY R (LCSW)
Entity Type:Individual
Prefix:
First Name:SHELLY
Middle Name:R
Last Name:MAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SHELLY
Other - Middle Name:R
Other - Last Name:HOCKING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:115 COMMONS WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-1906
Mailing Address - Country:US
Mailing Address - Phone:406-298-3632
Mailing Address - Fax:406-560-1166
Practice Address - Street 1:115 COMMONS WAY STE 201
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1906
Practice Address - Country:US
Practice Address - Phone:406-298-3632
Practice Address - Fax:406-560-1166
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLAC 1196101YA0400X
MT8361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)