Shea Haury, LCPC
Individual provider Active NPI Professional Counselor · Red Bud, IL
NPI 1487790945 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487790945
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- Practice address
- 10257 State Route 3
Red Bud, IL 62278-4418 - Phone
- (618) 282-6233
- Fax
- (618) 282-6220
- NPI assigned
- Jan 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180004451 | IL | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | IL | Yes |
Addresses
Primary practice location
10257 State Route 3
Red Bud, IL 62278-4418
Mailing address
1116 Sycamore LN
Sparta, IL 62286-1053
Other names
- Shea Willis
Other providers in Red Bud, IL
- Rajendra Gupta
- Isabelle Hamilton
- Amber L Harriman
- Abby Lea Harris
- Steven L Harrison
- Amanda Lorin Taylor Hawkins
- Health Focus Inc
- Sarah E Heine
- Colton Henderson
- Ashley N Hentis
All providers in Red Bud, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.