MEDICARE: SALINA SHELTON LPC

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	101Y00000X	Counselor	72293	TX
2	101YP2500X	Professional Counselor
3	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	352921602	OTHER	TX	TEXAS PROVIDER IDENTIFICATION
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629480520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALINA SHELTON LPC

Provider Business Mailing Address
First Line	:	980 TALLEY RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-5228
Country	:	US
Telephone Number	:	210-617-3185
Fax Number	:

Provider Business Practice Location Address
First Line	:	980 TALLEY RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-5228
Country	:	US
Telephone Number	:	210-617-3185
Fax Number	:

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

Provider Enumeration Date	:	05/27/2014
Last Update Date	:	03/24/2026

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Directions to “ SALINA SHELTON LPC” Practice Location

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