MS. SHELLY LYNN KETELHUT MSE NCC CSAC NPI 1184871378

NPI Information

NPI: 1184871378
Provider Name: MS. SHELLY LYNN KETELHUT, MSE, NCC, CSAC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
1936B ALGOMA BLVD
OSHKOSH, WI
ZIP 54901
Phone: (920) 232-0208
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MS. Shelly Lynn Ketelhut, MSE, NCC, CSAC is an addiction (substance use disorder) counselor in Oshkosh, WI. MS. Shelly Lynn Ketelhut, MSE, NCC, CSAC NPI is 1184871378. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1936B ALGOMA BLVD
OSHKOSH, WI
ZIP 54901-104
Phone: (920) 232-0208
Fax: (844) 270-4612

The enumeration date for this NPI number is 8/19/2008 and was last updated on 10/8/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	4498-125	WISCONSIN	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	15566-130	WISCONSIN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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