Provider Demographics
NPI:1760033187
Name:UPTON, SHELBY M
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:M
Last Name:UPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:M
Other - Last Name:NINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC ASSOCIATE
Mailing Address - Street 1:1398 W MAYFIELD RD STE 220
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-2356
Mailing Address - Country:US
Mailing Address - Phone:682-777-4325
Mailing Address - Fax:877-805-4720
Practice Address - Street 1:1398 W MAYFIELD RD STE 220
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2356
Practice Address - Country:US
Practice Address - Phone:682-777-4325
Practice Address - Fax:877-805-4720
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-26
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81417101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional