Provider Demographics
NPI:1396545596
Name:SHELTER, YVETTE
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:
Last Name:SHELTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-5325
Mailing Address - Country:US
Mailing Address - Phone:980-430-9205
Mailing Address - Fax:704-799-8949
Practice Address - Street 1:242 E BROAD ST
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-5325
Practice Address - Country:US
Practice Address - Phone:980-430-9205
Practice Address - Fax:704-799-8949
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14641101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health