Provider Demographics
NPI:1225797608
Name:SMITH, SHELBY LYNN (MS, LCPC)
Entity type:Individual
Prefix:MRS
First Name:SHELBY
Middle Name:LYNN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:MISS
Other - First Name:SHELBY
Other - Middle Name:LYNN
Other - Last Name:BUNKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LCPC
Mailing Address - Street 1:926 MAIN ST STE 18
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-3359
Mailing Address - Country:US
Mailing Address - Phone:406-478-8852
Mailing Address - Fax:406-478-5828
Practice Address - Street 1:926 MAIN ST STE 18
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-3359
Practice Address - Country:US
Practice Address - Phone:406-478-8852
Practice Address - Fax:406-478-5828
Is Sole Proprietor?:No
Enumeration Date:2021-12-13
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-52005101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional