MEDICARE: SHELBY WILLIAMS LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	1134	KS

General Provider Information

NPI Number	:	1700503042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELBY WILLIAMS LMFT

Provider Business Mailing Address
First Line	:	1518 E CARDINAL CT
Second Line	:
City	:	DERBY
State	:	KS
Zip	:	67037-3642
Country	:	US
Telephone Number	:	316-249-8920
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 E MADISON AVE STE 200
Second Line	:
City	:	DERBY
State	:	KS
Zip	:	67037-1736
Country	:	US
Telephone Number	:	316-789-6141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2022
Last Update Date	:	10/27/2022

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Directions to “ SHELBY WILLIAMS LMFT” Practice Location

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