MR. MATTHEW RYAN SHELLY QMHP - NPI 1215425772

Q: What is Matthew Shelly's NPI number?

The NPI number for Matthew Shelly is 1215425772. It was assigned to this individual provider in the NPPES registry on April 30, 2018.

Q: What is Matthew Shelly's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Matthew Shelly was last updated on April 30, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Mr. Matthew Ryan Shelly Qmhp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MATTHEW RYAN SHELLY QMHP (NPI 1215425772) is an individual mental health provider in Leesburg, Virginia and active in the NPI registry since April 2018.

NPPES Registry Identity

NPI1215425772

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameMR. MATTHEW RYAN SHELLYCredential: QMHP

Location Address102 HERITAGE WAY NE STE 302Leesburg, VA 20176-4544

Mailing Address102 Heritage Way Ne Ste 302Leesburg, VA 20176-4544 · (703) 771-5100 · Fax (703) 777-0170

Phone(703) 771-5100

Fax(703) 777-0170

Sole ProprietorYes

Enumeration DateApril 30, 2018

✔ NPI 1215425772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

102 HERITAGE WAY NE STE 302, Leesburg, VA 20176

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE CAMPBELL

Case Manager/Care Coordinator