Individual provider Active NPI

Shanae Stiles, AA PSYCHOLOGY

  • Addiction (Substance Use Disorder) Counselor
  • Lodi, CA
National Provider Identifier
1437002664
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
24768 Issued in CA
Practice address
541 S Ham LN Ste a
Lodi, CA 95242-3530
Phone
(200) 685-1999
NPI assigned
Feb 17, 2026
Last updated
Feb 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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 24768 CA Primary

Addresses

Primary practice location

541 S Ham LN Ste a
Lodi, CA 95242-3530

Mailing address

541 S Ham LN Ste a&B
Lodi, CA 95242-3059
Phone (209) 224-8940

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
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Treatment Centers, LLC Past Accepting new patients
Aegis Treatment Centers, LLC PastSince Dec 15, 2019 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1771286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1437002664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 S HAM LN STE A&B",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423059",
            "telephone_number": "209-224-8940",
            "fax_number": "209-224-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 S HAM LN STE A",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423530",
            "telephone_number": "200-685-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILES",
        "first_name": "SHANAE",
        "name_prefix": "Miss",
        "credential": "AA PSYCHOLOGY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-17",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "24768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; 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.