Individual provider Active NPI

Shaen McElravy, MSW, LAC

  • Addiction (Substance Use Disorder) Counselor
  • Missoula, MT
National Provider Identifier
1144338955
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
821 Issued in MT
Practice address
1325 Wyoming St
Missoula, MT 59801-1725
Phone
(406) 532-9810
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 821 MT Primary

Addresses

Primary practice location

1325 Wyoming St
Missoula, MT 59801-1725

Mailing address

T-9 Fort Missoula
Missoula, MT 59804-7202
Phone (406) 532-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
821MTMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144338955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "T-9 FORT MISSOULA",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047202",
            "telephone_number": "406-532-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 WYOMING ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598011725",
            "telephone_number": "406-532-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCELRAVY",
        "first_name": "SHAEN",
        "name_prefix": "Mr.",
        "credential": "MSW, LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.