Provider Demographics
NPI:1750632741
Name:KEIRN, SHELBY (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:KEIRN
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13801 N DALE MABRY HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2412
Mailing Address - Country:US
Mailing Address - Phone:813-777-9200
Mailing Address - Fax:
Practice Address - Street 1:13801 N DALE MABRY HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2412
Practice Address - Country:US
Practice Address - Phone:813-777-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health