MR. SHELBY QUALLS CAC-1 NPI 1194847749

NPI Information

NPI: 1194847749
Provider Name: MR. SHELBY QUALLS, CAC-1
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
8809 JOHN C LODGE
DETROIT, MI
ZIP 48224
Phone: (313) 887-6737
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MR. Shelby Qualls, CAC-1 is an addiction (substance use disorder) counselor in Detroit, MI. MR. Shelby Qualls, CAC-1 NPI is 1194847749. 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:

8809 JOHN C LODGE
DETROIT, MI
ZIP 48224
Phone: (313) 887-6737
Fax: (313) 876-0532

The enumeration date for this NPI number is 4/4/2007 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)	820080	MICHIGAN	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: 11/14/2023

NPI Synchronization or Removal

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