Healthcare Provider Details

I. General information

NPI: 1952469660
Provider Name (Legal Business Name): SHELLY L PROPER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 WEST SPRING STREET
TITUSVILLE PA
16354
US

IV. Provider business mailing address

115 WEST SPRING STREET
TITUSVILLE PA
16354
US

V. Phone/Fax

Practice location:
  • Phone: 814-827-2790
  • Fax: 814-827-4364
Mailing address:
  • Phone: 814-827-2790
  • Fax: 814-827-4364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC004284
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPC004284
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: