Provider Demographics
NPI:1407722010
Name:VANSCOYOC, SHELBY (LLPC)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:VANSCOYOC
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8796 15 MILE RD
Mailing Address - Street 2:
Mailing Address - City:EVART
Mailing Address - State:MI
Mailing Address - Zip Code:49631-8380
Mailing Address - Country:US
Mailing Address - Phone:231-388-3603
Mailing Address - Fax:
Practice Address - Street 1:1131 E CENTER ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:MI
Practice Address - Zip Code:48847-1603
Practice Address - Country:US
Practice Address - Phone:989-875-5101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451024524101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional