MEDICARE: SHELTON BEHAVIORAL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor
3	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1487264289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHELTON BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	556 NILES CORTLAND RD SE
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-2433
Country	:	US
Telephone Number	:	330-647-6207
Fax Number	:

Provider Business Practice Location Address
First Line	:	556 NILES CORTLAND RD SE
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-2433
Country	:	US
Telephone Number	:	330-647-6207
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KELSEY SHELTON
Credential	:	PSYD
Telephone Number	:	859-462-0066

Provider Enumeration Date	:	08/06/2020
Last Update Date	:	12/20/2023

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