Provider Demographics
NPI:1720979198
Name:WILSON, SHELBY LYNN (MED)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:LYNN
Last Name:WILSON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:LYNN
Other - Last Name:MISHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:12633 MOLLY PITCHER HWY
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:17225-9442
Mailing Address - Country:US
Mailing Address - Phone:814-414-7792
Mailing Address - Fax:
Practice Address - Street 1:550 CLEVELAND AVE STE 107
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-3430
Practice Address - Country:US
Practice Address - Phone:717-495-2812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health