MEDICARE: MS. SHELLEY LEE WEBER LMFT, LADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	1105L	NV
2	106H00000X	Marriage & Family Therapist	0967	NV

General Provider Information

NPI Number	:	1083761688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHELLEY LEE WEBER LMFT, LADC

Provider Business Mailing Address
First Line	:	9768 SHADYMILL AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1674
Country	:	US
Telephone Number	:	702-371-0406
Fax Number	:	702-363-2780

Provider Business Practice Location Address
First Line	:	2921 N TENAYA WAY
Second Line	:	SUITE 217
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1409
Country	:	US
Telephone Number	:	702-371-0406
Fax Number	:	702-363-2780

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

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	09/11/2025

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