Wilfred Shirley, SUBSTANCE ABUSE COUN

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1/2 Mile Northeast Dilkon Bashas Store
Winslow, AZ 86047

Phone

(928) 657-8000

Fax

(928) 657-8009

NPI assigned

Jul 2, 2019

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

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.

• Dilkon Outpatient Treatment Center

  • Community/Behavioral Health Agency
  • Winslow, AZ
  • NPI 1528270113

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1790347573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7072",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "860477072",
            "telephone_number": "928-657-8000",
            "fax_number": "928-657-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1/2 MILE NORTHEAST DILKON BASHAS STORE",
            "city": "WINSLOW",
            "state": "AZ",
            "postal_code": "86047",
            "telephone_number": "928-657-8000",
            "fax_number": "928-657-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRLEY",
        "first_name": "WILFRED",
        "credential": "SUBSTANCE ABUSE COUN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew D Scott, PMHNP
• John J Sears, MD
• Jong Bum Seo, DMD
• Lindsay Beth Sheets
• Roberta Shields
• Ottilia Sibanda, NP
• Thomasita Doeann Silas, CPHT
• Cheryle Ann Singer, DMD
• Shannon Kim Slaton, RN
• James Ernest Smith, P.A.-C

• Addiction (Substance Use Disorder) Counselor in Winslow, AZ
• Providers in Winslow, AZ by specialty
• Addiction (Substance Use Disorder) Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.