MEDICARE: MRS. SHELBY SMITH MATRONI LMHC

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	101YM0800X	Mental Health Counselor	10937	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10937	OTHER	MA	LICENSURE LMHC

General Provider Information

NPI Number	:	1851738116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHELBY SMITH MATRONI LMHC

Provider Business Mailing Address
First Line	:	2 BUNKER CIR
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01108-3473
Country	:	US
Telephone Number	:	413-426-7099
Fax Number	:

Provider Business Practice Location Address
First Line	:	1029 NORTH RD
Second Line	:
City	:	WESTFIELD
State	:	MA
Zip	:	01085-9711
Country	:	US
Telephone Number	:	413-579-8539
Fax Number	:

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

Provider Enumeration Date	:	05/28/2013
Last Update Date	:	09/08/2019

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