Provider Demographics
NPI:1710593280
Name:MESSICK - MILLER, SHELBI MARIA (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:SHELBI
Middle Name:MARIA
Last Name:MESSICK - MILLER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SHELBI
Other - Middle Name:MARIA
Other - Last Name:MESSICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:359 BALLSTON AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-4723
Mailing Address - Country:US
Mailing Address - Phone:518-587-8008
Mailing Address - Fax:
Practice Address - Street 1:359 BALLSTON AVE
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-4723
Practice Address - Country:US
Practice Address - Phone:518-587-8008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010531-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health