Sheree Itza, M.ED, LCAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

87000203A Issued in IN

Practice address

6655 E US Highway 36 Ste 100
Avon, IN 46123

Phone

(888) 714-1927

Fax

(317) 745-9565

NPI assigned

Apr 24, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cleanslate Medical Group of Indiana LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Alexandria, IN
  • NPI 1023464294
  NPD
• Cummins Behavioral Health Systems, Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Avon, IN
  • NPI 1740232115
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1124516257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 E US HIGHWAY 36 STE 100",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461236646",
            "telephone_number": "888-714-1927",
            "fax_number": "317-745-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 E US HIGHWAY 36 STE 100",
            "city": "AVON",
            "state": "IN",
            "postal_code": "46123",
            "telephone_number": "888-714-1927",
            "fax_number": "317-745-9565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5638 Professional Cir",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462415042",
            "country_code": "US",
            "telephone_number": "888-714-1927",
            "fax_number": "317-247-8935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ITZA",
        "first_name": "SHEREE",
        "credential": "M.ED, LCAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87000203A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Neal Ingram, NP
• Bruce Christopher Inman, M.D.
• Integrative Health Care Services of Indiana
• Poonam Ishanpara, PSY.D.
• It'S Beautiful Home Care Servicesllc
• Miesha Antoinette Jackson, FNP-BC
• Tonea N Jackson, MSW
• Addie Lyn Jacobs, MS, OTD, OTR
• Megan E Jacobs, CPNP, PMHS
• Hera Jafri, DO

• Addiction (Substance Use Disorder) Counselor in Avon, IN
• Providers in Avon, IN by specialty
• Addiction (Substance Use Disorder) Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.