MARY KAY SHELTON – Mental Health Counselor, NPI 1629648407

MARY KAY SHELTON is a healthcare provider. based in Lakewood, Ohio. specializing in MENTAL HEALTH COUNSELOR. The NPI Number for MARY KAY SHELTON is 1629648407

Main info

Female
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
MARY KAY SHELTON
NPI
1629648407
Phone
(440) 708-8922
Address
1578 HOPKINS AVE
Enumeration Date
25 June 2021
Last Update Date
25 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4407088922
Graduation Year
2022 (4 years ago)
PAC ID
2163956897
Group Practice PAC ID
8921532664
Professional Enrollment ID
I20241118000255
Address ID
OH441074115LA14701AVEX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:4State licenses:0Digital endpointsOther names

2,538 MENTAL HEALTH COUNSELOR in OH

Provider Addresses for MARY KAY SHELTON

  • 1578 HOPKINS AVE

    LAKEWOOD, OH 441075037

    Phone: (440) 708-8922

    Type: Mailing

  • 16600 W SPRAGUE RD

    CLEVELAND, OH 441306318

    Phone: (440) 523-0370

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241118000255IMental Health CounselorOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44107)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8921532664View full group profile
NameSpecialtyState
Clinical Social WorkerOH
Clinical Social WorkerMA

Reviews

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Frequently asked questions

What is the registry number for MARY KAY SHELTON?
The registry entry for MARY KAY SHELTON shows NPI 1629648407.
Is MARY KAY SHELTON currently accepting referrals based on NPI status?
Registry metadata lists MARY KAY SHELTON as active.
What type of care does MARY KAY SHELTON provide?
MARY KAY SHELTON's profile centers on Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Which community is linked to MARY KAY SHELTON?
MARY KAY SHELTON shows a connection to Lakewood, Ohio in registry-derived data.
Who maintains MARY KAY SHELTON's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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