Individual provider · Type 1 NPI
Kelly Nicole Shackelford
Mental Health Counselor · Trophy Club, TX
NPI number
1609771450
Active
Practice location
905 Trophy Club Dr Ste 203
Trophy Club, TX 76262-5572
Mailing address
1400 Vino Rosso Ct
Southlake, TX 76092-8861
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 104026 (TX) |
Mental Health Counselor: Definition to come...
Other mental health counselor providers in Trophy Club
About NPI 1609771450
Kelly Nicole Shackelford's National Provider Identifier is 1609771450, issued on Oct 12, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Trophy Club, TX. The record was last updated on Oct 12, 2026.