Whalio Doctors

NPI 1003364969

Marvin Shelton, EDSEDDRSAP

Practitioner Clinic/Center Hazelwood, MO

Practice location

Address
6110 Howdershell Rd, Hazelwood, MO 63042-1170
Phone
(314) 942-9499
Mailing address
4166 Lindell Blvd APT 1b, Saint Louis, MO 63108-2923

Registered specialties (5)

Clinic/Center Primary
Ambulatory Health Care Facilities Taxonomy 261Q00000X
Addiction (Substance Use Disorder) Counselor
Behavioral Health & Social Service Providers Taxonomy 101YA0400X Licence 9374 (MO)
Professional Counselor
Behavioral Health & Social Service Providers Taxonomy 101YP2500X Licence 9374 (MO)
Case Manager/Care Coordinator
Other Service Providers Taxonomy 171M00000X
Mental Health Clinic/Center (Including Community Mental Health Center)
Ambulatory Health Care Facilities Taxonomy 261QM0801X

Registry record

NPI
1003364969
Entity type
Individual
Sex (as registered)
Male
NPI issued
20 Sep 2016
Record last updated
19 Sep 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.