Provider Demographics
NPI:1912441395
Name:DOLLEY, SHELBY (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:DOLLEY
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:888 10TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-3587
Mailing Address - Country:US
Mailing Address - Phone:319-214-0814
Mailing Address - Fax:
Practice Address - Street 1:888 10TH ST STE 102
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-3587
Practice Address - Country:US
Practice Address - Phone:319-214-0814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA086513101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health