Provider Demographics
NPI:1922529635
Name:LINK, SHELBY (MS, LPCC)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:LINK
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 HADLEY AVE
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45419-2610
Mailing Address - Country:US
Mailing Address - Phone:937-369-0863
Mailing Address - Fax:
Practice Address - Street 1:308 HADLEY AVE
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:OH
Practice Address - Zip Code:45419-2610
Practice Address - Country:US
Practice Address - Phone:937-369-0863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-03
Last Update Date:2024-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1700482101YM0800X
OHE.1901465101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health