Shelley Jean Whiteman I, CASAC-ADVANCED

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

12637 Issued in NY

Practice address

190 Main St
Tupper Lake, NY 12986-1018

Phone

(518) 359-5401

Fax

(518) 359-5401

NPI assigned

Jan 4, 2022

Last updated

Jan 4, 2022By 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

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1861153637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 MAIN ST",
            "city": "TUPPER LAKE",
            "state": "NY",
            "postal_code": "129861018",
            "telephone_number": "518-359-5401",
            "fax_number": "518-359-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 MAIN ST",
            "city": "TUPPER LAKE",
            "state": "NY",
            "postal_code": "129861018",
            "telephone_number": "518-359-5401",
            "fax_number": "518-359-5401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 John Munn Rd",
            "address_purpose": "LOCATION",
            "city": "Saranac Lake",
            "state": "NY",
            "postal_code": "129831341",
            "country_code": "US",
            "telephone_number": "518-420-7440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITEMAN",
        "first_name": "SHELLEY",
        "middle_name": "JEAN",
        "name_suffix": "I",
        "credential": "CASAC-ADVANCED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "12637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tupper Lake Central School District
• Tupper Lake Volunteer Ambulance & Emergency Squad Inc
• Walgreen Co (Walgreens #19706)
• Matthew S Warner, RPH
• Melanie Werenczak
• Steven D Wilson, DDS
• Howard Neal Ziegler, M.D.
• Jessica Zobel, MS SPECIAL EDUCATION

• Addiction (Substance Use Disorder) Counselor in Tupper Lake, NY
• Providers in Tupper Lake, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.