Michael N. Shanley, LCSW, LISAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LISAC-10254 Issued in AZ

Practice address

9405 S Avenida del Yaqui
Guadalupe, AZ 85283-2529

Phone

(480) 768-2026

Fax

(480) 768-2053

NPI assigned

Feb 13, 2007

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1396887402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9405 S AVENIDA DEL YAQUI",
            "city": "GUADALUPE",
            "state": "AZ",
            "postal_code": "852832529",
            "telephone_number": "480-768-2026",
            "fax_number": "480-768-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9405 S AVENIDA DEL YAQUI",
            "city": "GUADALUPE",
            "state": "AZ",
            "postal_code": "852832529",
            "telephone_number": "480-768-2026",
            "fax_number": "480-768-2053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANLEY",
        "first_name": "MICHAEL",
        "middle_name": "N.",
        "credential": "LCSW, LISAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LISAC-10254",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-10461",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "854580",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pascua Yaqui Tribe
• Pascua Yaqui Tribe
• Pascua Yaqui Tribe
• Gloria M Rosales, LISAC
• Grant Satterthwaite
• Michael Kevin Simonetti
• Jody Lynn Tierney, LCSW
• Oghenetega Ewefada Vance, FNP
• David T Wilson, DO
• Qi Wen Xin, D.O.

• Addiction (Substance Use Disorder) Counselor in Guadalupe, AZ
• Providers in Guadalupe, AZ by specialty
• Addiction (Substance Use Disorder) Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.