SAMANTHA MARIE SHELLEY (NPI# 1700282415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700282415 |
| Entity Type | Individual |
| Full Name | SAMANTHA MARIE SHELLEY |
| Credential | BS |
| Practice Address |
215 Se Jackson Street Roseburg OR 97470 |
| Practice Telephone | 5414646401 |
| Mailing Telephone | 5414646401 |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2014-11-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 1366697690 | 05 |
| Street Address |
215 SE JACKSON STREET |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97470 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851848477 | Enoch Nibblett | Counselor | 215 Se Jackson Street, Roseburg, OR 97470 | 2016-09-01 |
| 1609247071 | Nora Catherine Staum | Counselor | 215 Se Jackson Street, Roseburg, OR 97470 | 2015-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326547134 | Thoughtwork, LLC | Social Worker | 178 Nw Garden Valley Blvd, Roseburg, OR 97470 | 2018-02-07 |
| 1063932960 | Go Mo, LLC | Durable Medical Equipment & Medical Supplies | 627 Se Jackson St, Roseburg, OR 97470 | 2017-06-21 |
| 1497123335 | Brandi N Hamilton | Counselor | 215 S.e. Jackson, Roseburg, OR 97470 | 2015-09-09 |
| 1285031203 | Aric Fromdahl | Counselor | 215 Se Jackson, Roseburg, OR 97470 | 2014-11-20 |
| 1801292438 | Robin Knebel | Counselor | 215 Se Jackson St., Roseburg, OR 97470 | 2014-11-10 |
| 1043610660 | Cynthia Simmons | Counselor | 150 Ne Kenneth Ford Drive, Roseburg, OR 97470 | 2014-09-02 |
| 1083025431 | Toni Damewood Msn Pmhnp-bc | Nurse Practitioner | 770 Se Kane Street, Roseburg, OR 97470 | 2014-05-19 |
| 1801226196 | Denise Ingeman | Registered Nurse | 1548 South East Pine Street, Roseburg, OR 97470 | 2013-11-22 |
| 1356606909 | Carla Junette Rambel | Massage Therapist | 566 S.e. Jackson, Roseburg, OR 97470 | 2012-07-10 |
| 1700180098 | Rebekah Anna Syverson | Nurse Practitioner | 1318 Cattle Dr, Roseburg, OR 97470 | 2010-12-31 |
| Find all providers in zip 97470 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497123335 | Brandi N Hamilton | Counselor | 215 S.e. Jackson, Roseburg, OR 97470 | 2015-09-09 |
| 1285031203 | Aric Fromdahl | Counselor | 215 Se Jackson, Roseburg, OR 97470 | 2014-11-20 |
| 1801292438 | Robin Knebel | Counselor | 215 Se Jackson St., Roseburg, OR 97470 | 2014-11-10 |
| 1598012965 | Jane Lynn Docken | Counselor | 877 Ne Church Ave, Roseburg, OR 97470-1590 | 2012-08-05 |
| 1285886051 | Jon R Jackson | Counselor | 337 Fowler St, Roseburg, OR 97470 | 2008-10-10 |
| 1639321409 | Leslie Bennett | Counselor | 272 Nw Medical Loop Ste C, Roseburg, OR 97471-5545 | 2008-10-10 |
| 1225171721 | Holly Leeann Oltman | Counselor | 337 Fowler, Roseburg, OR 97470 | 2007-02-14 |
| 1891303152 | Roger Kennedy | Counselor | 1652 Nw Hughwood Ct, Roseburg, OR 97471-8844 | 2020-07-22 |
| 1912532599 | Nicki Golden Fox-morse | Counselor | 283 Se Fowler St Ste 2, Roseburg, OR 97470-3309 | 2020-03-04 |
| 1871142745 | Megan Pilar Watkins | Counselor | 283 Se Fowler St Ste 2, Roseburg, OR 97470-3309 | 2019-09-04 |
| Find all providers in ROSEBURG | ||||
Please comment or provide details below to improve the information on SAMANTHA MARIE SHELLEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.