Shelley I Goad
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · El Prado, NM
NPI 1023884384 · NPPES record last updated Nov 28, 2023
Key facts
- NPI
- 1023884384
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CAD0224081 (NM)
- Practice address
- 259 Blueberry Hill Rd
El Prado, NM 87529-7305 - Phone
- (214) 622-7543
- NPI assigned
- Nov 28, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| CAD0224081 | NM | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifehouse Vista Taos | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CAD0224081 | NM | Yes |
Addresses
Primary practice location
259 Blueberry Hill Rd
El Prado, NM 87529-7305
Mailing address
259 Blueberry Hill Rd
El Prado, NM 87529-7305
Phone (214) 622-7543
Other providers in El Prado, NM
- Donald L Flory
- Tony Froeschle
- Andrea Frost
- Erin M Fusting
- Heidi Gates
- Stephanie Greene
- Andrea Whyte Griffin
- Patrick Norman Hall
- Gaye Alexander Hawkins
- Nancy Hazen
All providers in El Prado, NM · Addiction (Substance Use Disorder) Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2023. 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.