Provider Demographics
NPI:1063590925
Name:HESS, SHELLY JEAN (MA,LPC)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:JEAN
Last Name:HESS
Suffix:
Gender:F
Credentials:MA,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3260 N HAYDEN RD
Mailing Address - Street 2:SUITE #105
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6649
Mailing Address - Country:US
Mailing Address - Phone:602-840-7130
Mailing Address - Fax:480-946-1079
Practice Address - Street 1:3260 N HAYDEN RD
Practice Address - Street 2:SUITE #105
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6649
Practice Address - Country:US
Practice Address - Phone:602-840-7130
Practice Address - Fax:480-946-1079
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-0309101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional