Anna Marie Shale, CDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP00006146 Issued in WA

Practice address

311 S I St
Aberdeen, WA 98520-6615

Phone

(360) 787-9319

Fax

(360) 637-8722

NPI assigned

Jul 9, 2010

Last updated

Nov 4, 2019By the provider in NPPES

Sex

Female

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

Locations

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.

• Lifeline Connections

  • Community/Behavioral Health Agency
  • Aberdeen, WA
  • NPI 1639719743
  NPD
• Columbia Wellness

  • Case Management Agency
  • Longview, WA
  • NPI 1487659579
  NPD (past)
• Lifeline Connections Medical Services

  • Primary Care Clinic/Center
  • Vancouver, WA
  • NPI 1245819887
  NPD (past)

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1780996553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 14TH AVENUE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "98632",
            "telephone_number": "360-423-0203",
            "fax_number": "360-577-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S I ST",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985206615",
            "telephone_number": "360-787-9319",
            "fax_number": "360-637-8722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALE",
        "first_name": "ANNA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "CDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00006146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sea-Mar Community Health Center
• Sea-Mar Community Health Center
• Sean R White MD PS
• Sean R. White, MD, PS
• Melissa Sexton, LICSWA
• Sholeh Bernadette Sharif
• Bijan Sheikhizadeh, DPM
• Eric Alan Shepard
• Kylie Dianne Shepard
• Janette Sheppard

• Addiction (Substance Use Disorder) Counselor in Aberdeen, WA
• Providers in Aberdeen, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.