MICHAEL N. SHANLEY LCSW LISAC NPI 1396887402

NPI Information

NPI: 1396887402
Provider Name: MICHAEL N. SHANLEY, LCSW, LISAC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
9405 S AVENIDA DEL YAQUI
GUADALUPE, AZ
ZIP 85283
Phone: (480) 768-2026
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Michael N. Shanley, LCSW, LISAC is an addiction (substance use disorder) counselor in Guadalupe, AZ. Michael N. Shanley, LCSW, LISAC NPI is 1396887402. 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:

9405 S AVENIDA DEL YAQUI
GUADALUPE, AZ
ZIP 85283-529
Phone: (480) 768-2026
Fax: (480) 768-2053

The enumeration date for this NPI number is 2/13/2007 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)	LISAC-10254	ARIZONA	Yes
2	1041C0700X	Social Worker	Clinical	LCSW-10461	ARIZONA	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	854580	MEDICAID	ARIZONA

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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