Provider Demographics
NPI:1902236383
Name:SHELTON, JENNIFER (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SHELTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SW CENTURY DR # 405-203
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3037
Mailing Address - Country:US
Mailing Address - Phone:503-567-8682
Mailing Address - Fax:855-975-2656
Practice Address - Street 1:320 SW CENTURY DR # 405-203
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3037
Practice Address - Country:US
Practice Address - Phone:503-567-8605
Practice Address - Fax:855-975-2656
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-20
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health