SHANE WAX (NPI# 1265864037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265864037 |
| Entity Type | Individual |
| Full Name | SHANE WAX |
| Credential | M.ED |
| Practice Address |
1233 State Rd Plymouth MA 02360-5133 |
| Practice Telephone | 5082247701 |
| Mailing Telephone | 5082247701 |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2013-08-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
1233 STATE RD |
| City | PLYMOUTH |
| State | MA |
| Zip Code | 02360-5133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083633580 | Michael J.f. Iannessa | Internal Medicine | 1233 State Rd, Plymouth, MA 02360-5133 | 2006-07-18 |
| 1831736586 | Brooke Fleming | Counselor | 1233 State Rd, Plymouth, MA 02360-5133 | 2019-12-02 |
| 1194367961 | Jessica Marie Rapoza | Counselor | 1233 State Rd, Plymouth, MA 02360-5133 | 2019-10-14 |
| 1164083952 | Destiny Marie Kerr | Counselor | 1233 State Rd, Plymouth, MA 02360-5133 | 2019-06-24 |
| 1720641210 | Matthew Hart | Counselor | 1233 State Rd, Plymouth, MA 02360-5133 | 2019-04-19 |
| 1073078507 | Christopher Matthew Englehart | Counselor | 1233 State Rd, Plymouth, MA 02360-5133 | 2019-02-08 |
| 1285117267 | Melissa Johnson | Counselor | 1233 State Rd, Plymouth, MA 02360-5133 | 2018-09-14 |
| 1629550967 | Denise Sharp | Counselor | 1233 State Rd, Plymouth, MA 02360-5133 | 2018-09-04 |
| 1366929218 | Amy Gabouny | Counselor | 1233 State Rd, Plymouth, MA 02360-5133 | 2018-07-24 |
| 1417440074 | Jennifer Theresa Louise Wylie | Counselor | 1233 State Rd, Plymouth, MA 02360-5133 | 2018-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801425053 | Geraldine Veronica Thissell | Speech-Language Pathologist | 28 Nathan Lane, Plymouth, MA 02360 | 2020-04-08 |
| 1447889621 | Corrections - Comprehensive Treatment Centers, LLC | Clinic/Center | One Bumps Pond Road, Plymouth, MA 02360 | 2020-04-08 |
| 1427690247 | Osp Children's Therapy Center | Physical Therapist | 130 Industrial Park Rd. A, Plymouth, MA 02360 | 2019-10-14 |
| 1265996219 | Housecall Physicians, Inc | Family Medicine | 31 Home Depot Drive, Suite 283, Plymouth, MA 02360 | 2019-01-24 |
| 1306329271 | Patricia Jane Whitaker | Social Worker | Masac-plymouth, 1 Bumps Pond Road, Plymouth, MA 02360 | 2018-09-07 |
| 1366934572 | Cindy Oneil | Registered Nurse | 10 Cordage Park, Plymouth, MA 02360 | 2018-06-04 |
| 1275021685 | Alexandra Andrew | Acupuncturist | 225 Water St Ste B239, Plymouth, MA 02360 | 2018-05-01 |
| 1417445289 | Susan Ann Adams | Case Manager/Care Coordinator | 260 Ship Pond Rd, Plymouth, MA 02360 | 2018-04-27 |
| 1588178776 | Cassandra Noel Denayer | Registered Nurse | 7 Rodman Lane, Plymouth, MA 02360 | 2017-11-27 |
| 1205345576 | Chibueze George Okoro | Dentist | Dr Dental 125 Samoset Street, Plymouth, MA 02360 | 2017-09-29 |
| Find all providers in zip 02360 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487272787 | Alec Medeiros | Counselor | 16 Chickadee Way, Plymouth, MA 02360-1659 | 2020-07-13 |
| 1215569991 | Jessica Lynn Payne | Counselor | 260 S Union St, Plymouth, MI 48170-1612 | 2020-02-10 |
| 1699316117 | Kevin Louis Avitabile | Counselor | 62 Nautical Way, Plymouth, MA 02360-8611 | 2019-10-06 |
| 1194383323 | Passera Counseling, Pllc | Counselor | 42327 Ann Arbor Rd E, Plymouth, MI 48170-4356 | 2019-06-03 |
| 1316439763 | Aman Patel | Counselor | 200 Carver Rd, Plymouth, MA 02360-5210 | 2018-06-01 |
| 1255867230 | Sandra Somerville | Counselor | 933 Long Pond Rd, Plymouth, MA 02360-2635 | 2017-05-11 |
| 1346797438 | Barbara Lydon | Counselor | 118 Long Pond Rd Ste 106, Plymouth, MA 02360-2662 | 2016-09-06 |
| 1679020234 | Lisa Stringer | Counselor | 22 Jasons Lane, Plymouth, MA 02360 | 2016-09-01 |
| 1194173948 | William David Hunt IIi | Counselor | 164 Raymond Rd, Plymouth, MA 02360-2357 | 2016-06-01 |
| 1972959872 | Gregory Dominick Sorensen | Counselor | 18 Hopkins Road, Plymouth, MA 02360-3547 | 2016-05-10 |
| Find all providers in PLYMOUTH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.