Shonda N White

Individual provider Active NPI Counselor · Cascade, CO

NPI 1912671595 · NPPES record last updated Aug 5, 2021

Key facts

NPI
1912671595
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
Practice address
9550 Mountain Rd
Cascade, CO 80809-1524
Phone
(217) 341-0750
NPI assigned
Aug 5, 2021
Sex
Female
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101Y00000X Yes

Addresses

Primary practice location

9550 Mountain Rd
Cascade, CO 80809-1524

Mailing address

9550 Mountain Rd
Cascade, CO 80809-1524

Other providers in Cascade, CO

All providers in Cascade, CO · Counselor in Colorado

Sources for this page

Verify at the official NPI Registry.