Shawn Halverstadt, LCDC III
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Columbiana, OH
NPI 1003354804 · NPPES record last updated Feb 2, 2017
Key facts
- NPI
- 1003354804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 1211148 (OH)
- Practice address
- 49 Pueblo LN
Columbiana, OH 44408-8407 - Phone
- (330) 692-3395
- NPI assigned
- Feb 1, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1211148 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| 8291 | PA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1211148 | OH | Yes |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 8291 | PA |
Addresses
Primary practice location
49 Pueblo LN
Columbiana, OH 44408-8407
Mailing address
49 Pueblo LN
Columbiana, OH 44408-8407
Phone (330) 692-3395
Other providers in Columbiana, OH
- Braydon Gibson
- Maria Greier
- Lori Jean Grenich
- Steven David Grossman
- Albert J Guarnieri
- Healme Inc
- Healme Inc
- Hearing AIDS and Devices Inc
- Darby Heiland
- John Alex Heintzelman
All providers in Columbiana, OH · Addiction (Substance Use Disorder) Counselor in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.