Mason P Shallow

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

20605-130 Issued in WI

Practice address

PO Box 1550
Rhinelander, WI 54501-1550

Phone

(715) 362-5745

Fax

(715) 362-2819

NPI assigned

Jun 21, 2024

Sex

Male

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

State licenses

Practice roles

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

• Options Counseling Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greendale, WI
  • NPI 1720369366
  NPD (past)
• The Human Service Center Koinonia Residential Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Rhinelander, WI
  • NPI 1932301306
  NPD (past)

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

{
    "created_epoch": "1718928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1780428979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1550",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545011550",
            "telephone_number": "715-362-5745",
            "fax_number": "715-362-2819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 1550",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545011550",
            "telephone_number": "715-362-5745",
            "fax_number": "715-362-2819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALLOW",
        "first_name": "MASON",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-21",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "20605-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annette Ellen Scott-Chadwell, RN
• Jeffrey L Seabloom, RPH
• Linda Seiter, APNP
• Melissa Sellmeyer
• Rita Jean Semmerling, LPC
• Nathan Lee Shefveland, M.D.
• Mary Susan Shepherd, RN-RCS
• Donna Mae Shimeck, MA
• Theodore J Shinners, MD
• Shopko Stores Operating Co LLC

• Addiction (Substance Use Disorder) Counselor in Rhinelander, WI
• Providers in Rhinelander, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; 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.