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General NPI Number Information
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NPI Number | 1831053354
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Entity Type | Individual
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Provider Name | SHELBIE BOUCK LCMHC
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Gender | Female
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 165 N 100 E STE 8
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City | ST GEORGE
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State | UT
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Zip | 84770-2505
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Country | US
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Telephone | 435-216-0909
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Fax |
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Provider Business Mailing Address
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Address Line | 369 N 2480 W
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City | HURRICANE
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State | UT
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Zip | 84737-3511
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 12821981-6004
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License Number State | UT
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