Healthcare Provider Details

I. General information

NPI: 1679196281
Provider Name (Legal Business Name): SHELBY KATHRYN EGAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2020
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 PENN AVE STE 305
WYOMISSING PA
19610-2100
US

IV. Provider business mailing address

130 MEDINAH DR
READING PA
19607-3700
US

V. Phone/Fax

Practice location:
  • Phone: 484-336-0915
  • Fax:
Mailing address:
  • Phone: 484-336-0915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC012242
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: