# SHELIA TYRELL CISCO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1518411131
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | Yes |
| 101YP2500X | Professional Counselor | 180.017063 | IL | — |

## Other

- **Enumeration date:** 08/11/2016
- **Last updated:** 05/12/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 180.017063 | STATE LICENSE | IL |
| 05 | — | 370915481007 | — | IL |