Provider Demographics
NPI:1730784760
Name:SMITH, SHELBY LYNN BECKMAN (LPC, NCC)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:LYNN BECKMAN
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 STODDARD RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062-2505
Mailing Address - Country:US
Mailing Address - Phone:810-392-2167
Mailing Address - Fax:810-392-3530
Practice Address - Street 1:400 STODDARD RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MI
Practice Address - Zip Code:48062-2505
Practice Address - Country:US
Practice Address - Phone:810-392-2167
Practice Address - Fax:810-392-3530
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401018748101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional