MEDICARE: SHELLE M MATHIS COUNSELING SERVICES LLC

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

General Provider Information

NPI Number	:	1932068400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHELLE M MATHIS COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	611 GARFIELD AVE
Second Line	:
City	:	ELYRIA
State	:	OH
Zip	:	44035-3403
Country	:	US
Telephone Number	:	330-577-8548
Fax Number	:	888-885-9854

Provider Business Practice Location Address
First Line	:	611 GARFIELD AVE
Second Line	:
City	:	ELYRIA
State	:	OH
Zip	:	44035-3403
Country	:	US
Telephone Number	:	330-577-8548
Fax Number	:	888-885-9854

Authorized Official
Title or Position	:	CEO
Name	:	MS. SHELLE M MATHIS
Credential	:	LPCC
Telephone Number	:	440-452-6544

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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