Provider Demographics
NPI:1649089129
Name:CAIN, SHELBI LYNN
Entity type:Individual
Prefix:
First Name:SHELBI
Middle Name:LYNN
Last Name:CAIN
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 1:3087 COUNTY ROAD 811
Mailing Address - Street 2:
Mailing Address - City:GREEN FOREST
Mailing Address - State:AR
Mailing Address - Zip Code:72638-4031
Mailing Address - Country:US
Mailing Address - Phone:870-414-3604
Mailing Address - Fax:
Practice Address - Street 1:104 LOCK AND DAM RD
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72802-9725
Practice Address - Country:US
Practice Address - Phone:479-747-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator