Shasta Wease

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

907 N Mulberry St Ste 200
Elizabethtown, KY 42701-2018

Phone

(270) 982-7372

Fax

(270) 982-7372

NPI assigned

Oct 18, 2022

Last updated

Oct 18, 2022By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1255057402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 FRONTIER CT APT 1",
            "city": "RADCLIFF",
            "state": "KY",
            "postal_code": "401609075",
            "telephone_number": "502-353-8277",
            "fax_number": "270-982-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 N MULBERRY ST STE 200",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012018",
            "telephone_number": "270-982-7372",
            "fax_number": "270-982-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEASE",
        "first_name": "SHASTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie A. Wathen
• Tracy Monique Wathen, LCSW
• Taelore Watkins
• Andrea Watson, MD
• Nicholas Watters, PSYD
• Debra Carol Weaver, CADC1
• Hannah Lee Weaver, CSW
• Billie Jo Webb
• Deborah Webb, CADC
• Sarah Weeks

• Peer Specialist in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Peer Specialist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.