Provider Demographics
NPI:1396430237
Name:CASE, SHELBY NICOLE (MED, LPCA)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:NICOLE
Last Name:CASE
Suffix:
Gender:F
Credentials:MED, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3932
Mailing Address - Street 2:
Mailing Address - City:WEST SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42564-3932
Mailing Address - Country:US
Mailing Address - Phone:606-401-2966
Mailing Address - Fax:606-244-4111
Practice Address - Street 1:11902 BRINLEY AVE STE 100
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40243-3000
Practice Address - Country:US
Practice Address - Phone:606-401-2966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY275165101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor