Individual
MICHAEL SHELBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
151 NEW PARK AVE UNIT 7, HARTFORD, CT 06106-2191
(833) 475-2623
Mailing address
PO BOX 370104, WEST HARTFORD, CT 06137-0104
(860) 796-7151
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
003981
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003981
LPC LICENSE
CT
Enumeration date
07/21/2020
Last updated
07/21/2020
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