Gordon F Shrader, LADC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Honolulu, HI
NPI 1720177645 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720177645
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 114L (NV)
- Practice address
- 459 Patterson Rd
Honolulu, HI 96819-1522 - Phone
- (808) 935-3781
- Fax
- (808) 935-6692
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- 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 |
|---|---|---|---|
| 114L | NV | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 114L | NV | Yes |
Addresses
Primary practice location
459 Patterson Rd
Honolulu, HI 96819-1522
Mailing address
459 Patterson Rd
Honolulu, HI 96819-1522
Phone (808) 935-3781
Other providers in Honolulu, HI
- Kyle Shoji
- Peter J. Shoji
- Pamela Anne Short
- Brandt Shortland Te Koha Koi Shortland Jr.
- Amber Rae Shotkoski
- Rajesh Shrestha
- Mackenzie Marina Shribbs
- Shriners Hospitals for Children
- Shriners Hospitals for Children
- Shriners Hospitals for Children
All providers in Honolulu, HI · Addiction (Substance Use Disorder) Counselor in Hawaii
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.