MS. MARIE ANN SHADE LCPC NPI 1609945831

NPI Information

NPI: 1609945831
Provider Name: MS. MARIE ANN SHADE, LCPC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
684 N 9TH STREET
BOISE, ID
ZIP 85702
Phone: (208) 343-6636
Get Directions

MS. Marie Ann Shade, LCPC is an addiction (substance use disorder) counselor in Boise, ID. MS. Marie Ann Shade, LCPC NPI is 1609945831. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

684 N 9TH STREET
BOISE, ID
ZIP 85702-458
Phone: (208) 343-6636
Fax: (208) 389-1474

The enumeration date for this NPI number is 11/6/2006 and was last updated on 7/8/2007.

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	101YA0400X	Counselor	Addiction (Substance Use Disorder)	LCPC44	IDAHO	Yes
2	101YM0800X	Counselor	Mental Health	LCPC44	IDAHO	X
3	101YP2500X	Counselor	Professional	LCPC44	IDAHO	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000010016630	OTHER	IDAHO	REGENCE BLUE SHIELD
2	Q1687	OTHER	IDAHO	BLUE CROSS

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: 4/28/2024

NPI Synchronization or Removal

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