SHELLY JECC ESPEJO LAC
NPI 1568087203
Counselor - Mental Health in Newark, NJ
About Shelly Jecc Espejo Lac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHELLY JECC ESPEJO LAC (NPI 1568087203) is an individual mental health provider in Newark, New Jersey, licensed in New Jersey (37PC01062200) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shelly Jecc Espejo Lac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
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.
NEWARK, NJ 07103
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Shelly Espejo's NPI number?
The NPI number for Shelly Espejo is 1568087203. It was assigned to this individual provider in the NPPES registry on June 9, 2020.
Where is Shelly Espejo located?
Shelly Espejo practices at 183 S Orange Ave, Newark, NJ 07103. The listed phone number is (800) 969-5300.
What is Shelly Espejo's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.
Is Shelly Espejo enrolled in Medicare?
Yes. Shelly Espejo is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Shelly Espejo was last updated on November 7, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Shelly Jecc Espejo, LAC · NPI 1568087203
Mental Health provider in Newark, New Jersey. Individual provider, active in the CMS NPPES registry since June 9, 2020.
## Identity
- **NPI:** 1568087203 (Entity type: Individual)
- **Enumerated:** June 9, 2020
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **State license:** 37PC01062200 (New Jersey)
- **Sole proprietor:** No
## Practice location
- **Address:** 183 S ORANGE AVE, Newark, NJ 07103-2757
- **Phone:** (800) 969-5300
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** November 7, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1568087203) · Data from the CMS NPPES public registry.