Provider Demographics
NPI:1083117105
Name:SHELTON, KATHERYN LEIGH (LMHC, ATR)
Entity type:Individual
Prefix:
First Name:KATHERYN
Middle Name:LEIGH
Last Name:SHELTON
Suffix:
Gender:F
Credentials:LMHC, ATR
Other - Prefix:
Other - First Name:KATHERYN
Other - Middle Name:LEIGH
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14847 SENATOR WAY
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5128
Mailing Address - Country:US
Mailing Address - Phone:812-661-8356
Mailing Address - Fax:
Practice Address - Street 1:600 E CARMEL DR STE 119
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3049
Practice Address - Country:US
Practice Address - Phone:317-300-5362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-15
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003241A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health