Individual
SHELBY DEBAUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
2202 EXECUTIVE DR, SUITE C, HAMPTON, VA 23666-6604
(757) 827-7707
(757) 838-2573
Mailing address
2202 EXECUTIVE DR, SUITE C, HAMPTON, VA 23666-6604
(757) 827-7707
(757) 838-2573
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
717001078
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
191690
ANTHEM
VA
01
—
239462
COMPSYCH
—
01
—
339586
MANAGED HEALTH NET/TRICARE
—
01
—
7050631
AETNA
—
01
—
738916000
MAGELLAN
—
01
—
O80718M
SENTARA HEALTH MANAGEMENT
VA
01
—
PK100082781
AMERICAN PYCH SERVICES
—
Enumeration date
06/20/2006
Last updated
03/04/2013
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