Provider Demographics
NPI:1609514009
Name:SHELTON, LINCOLN (LPC,MHSP)
Entity Type:Individual
Prefix:
First Name:LINCOLN
Middle Name:
Last Name:SHELTON
Suffix:
Gender:M
Credentials:LPC,MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 BRISTOL HWY
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTON
Mailing Address - State:TN
Mailing Address - Zip Code:37643-6684
Mailing Address - Country:US
Mailing Address - Phone:423-747-3803
Mailing Address - Fax:
Practice Address - Street 1:1180 BRISTOL HWY
Practice Address - Street 2:
Practice Address - City:ELIZABETHTON
Practice Address - State:TN
Practice Address - Zip Code:37643-6684
Practice Address - Country:US
Practice Address - Phone:423-747-8033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5132101YA0400X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional