MR. PETER SHANE KIDNOCKER CDCA NPI 1376141564

NPI Information

NPI: 1376141564
Provider Name: MR. PETER SHANE KIDNOCKER, CDCA
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
519 COURT ST
PORTSMOUTH, OH
ZIP 45662
Phone: (740) 876-4370
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MR. Peter Shane Kidnocker, CDCA is an addiction (substance use disorder) counselor in Portsmouth, OH. MR. Peter Shane Kidnocker, CDCA NPI is 1376141564. 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:

519 COURT ST
PORTSMOUTH, OH
ZIP 45662-933
Phone: (740) 876-4370
Fax: (740) 529-1313

The enumeration date for this NPI number is 10/12/2020 and was last updated on 10/12/2020.

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)			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: 4/28/2024

NPI Synchronization or Removal

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