Provider Demographics
NPI:1205553658
Name:ELLIOTT, SHELBY HOPE (LCPC)
Entity type:Individual
Prefix:MS
First Name:SHELBY
Middle Name:HOPE
Last Name:ELLIOTT
Suffix:
Gender:
Credentials:LCPC
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:HOPE
Other - Last Name:BISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:328 N POTOMAC ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-3820
Mailing Address - Country:US
Mailing Address - Phone:301-733-6063
Mailing Address - Fax:
Practice Address - Street 1:328 N POTOMAC ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-3820
Practice Address - Country:US
Practice Address - Phone:301-733-6063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC13876101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional