MEDICARE: SHELBY MARIE PASKE

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	101YP2500X	Professional Counselor	A22837	NC
2	101Y00000X	Counselor	A22837	NC
3	101YM0800X	Mental Health Counselor	A22837	NC

General Provider Information

NPI Number	:	1053252346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELBY MARIE PASKE

Provider Business Mailing Address
First Line	:	4041 BREEZEWOOD DR APT 9107
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-5296
Country	:	US
Telephone Number	:	859-533-7958
Fax Number	:

Provider Business Practice Location Address
First Line	:	4041 BREEZEWOOD DR APT 9107
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-5296
Country	:	US
Telephone Number	:	859-533-7958
Fax Number	:

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

Provider Enumeration Date	:	04/02/2026
Last Update Date	:	04/27/2026

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