Shandi Lynn Ellis
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Augusta, ME
NPI 1104631019 · NPPES record last updated Feb 8, 2025
Key facts
- NPI
- 1104631019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CAC8759 (ME)
- Practice address
- 10 Caldwell Rd
Augusta, ME 04330-5735 - Phone
- (207) 626-3448
- NPI assigned
- Feb 8, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| CAC8759 | ME | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CAC8759 | ME | Yes |
Addresses
Primary practice location
10 Caldwell Rd
Augusta, ME 04330-5735
Mailing address
22 North St Apt 3
Augusta, ME 04330-5009
Phone (207) 458-2356
Other providers in Augusta, ME
- Dawn Ego
- Felix Temitope Elijah
- Allyson Eller
- Katelyn Grace Ellis
- Shaina Daley Ellis
- James Elmore
- Peter W Elvin
- Amy Marie Elwell
- Laura Elwell
- Edith L Emerson
All providers in Augusta, ME · Addiction (Substance Use Disorder) Counselor in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2025. 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.