Healthcare Provider Details

I. General information

NPI: 1982534061
Provider Name (Legal Business Name): SHELBY JEAN HALL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 S MARKET ST STE 205
WOOSTER OH
44691-4765
US

IV. Provider business mailing address

165 CIRCLE DR
DOYLESTOWN OH
44230-1441
US

V. Phone/Fax

Practice location:
  • Phone: 330-606-2478
  • Fax:
Mailing address:
  • Phone: 330-606-2478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2607763
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: