Provider Demographics
NPI:1497908438
Name:GEARY, SHELLEY M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:M
Last Name:GEARY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:SHELLEY
Other - Middle Name:
Other - Last Name:GOULD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, LIMHP, LMHP
Mailing Address - Street 1:3210 S GILBERT RD
Mailing Address - Street 2:STE 1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-5108
Mailing Address - Country:US
Mailing Address - Phone:541-806-3747
Mailing Address - Fax:
Practice Address - Street 1:3210 S GILBERT RD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-5108
Practice Address - Country:US
Practice Address - Phone:541-806-3747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2021-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3099101YM0800X
NE1210101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ17768OtherAZ LICENSE PROFESSIONAL COUNSELOR