Provider Demographics
NPI:1942079181
Name:FRIERY, SHELBY K (PHD, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:K
Last Name:FRIERY
Suffix:
Gender:F
Credentials:PHD, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6067 S PLATEAU VIEW WAY
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83716-7023
Mailing Address - Country:US
Mailing Address - Phone:509-431-2984
Mailing Address - Fax:
Practice Address - Street 1:6067 S PLATEAU VIEW WAY
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83716-7023
Practice Address - Country:US
Practice Address - Phone:509-431-2984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-10106101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional