Individual
MS. SHELLY A MENTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, MCAP
Contact information
Practice address
10428 YELLOW SPICE CT, RIVERVIEW, FL 33578-3410
(813) 830-8055
(813) 319-5447
Mailing address
10428 YELLOW SPICE CT, RIVERVIEW, FL 33578-3410
(718) 662-6473
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
MH23899
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015558700
—
FL
01
—
MH23899
IRS
FL
Enumeration date
05/26/2017
Last updated
06/26/2024
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