Provider Demographics
NPI:1679196281
Name:BRIGHTBILL, SHELBY KATHRYN (LPC)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:KATHRYN
Last Name:BRIGHTBILL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 HILL AVE APT 2737
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-2042
Mailing Address - Country:US
Mailing Address - Phone:484-336-0915
Mailing Address - Fax:
Practice Address - Street 1:1287 PENN AVE
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2129
Practice Address - Country:US
Practice Address - Phone:484-514-9764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012242101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional