SHANE SOUDEK NPI 1063293033

NPI Information

NPI: 1063293033
Provider Name: SHANE SOUDEK
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address:
1007 CROWN DR
EDMOND, OK
ZIP 73034
Phone: (405) 368-7229
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Shane Soudek is a peer specialist in Edmond, OK. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. Shane Soudek NPI is 1063293033. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1007 CROWN DR
EDMOND, OK
ZIP 73034-535
Phone: (405) 368-7229

The enumeration date for this NPI number is 10/6/2023 and was last updated on 10/6/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	175T00000X	Peer Specialist				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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