MELISSA A SHANE (NPI# 1326476482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326476482 |
| Entity Type | Individual |
| Full Name | MELISSA A SHANE |
| Credential | LCPC |
| Practice Address |
3020 W. Willow Knolls Drive Peoria IL 61614-1002 |
| Practice Telephone | 3096815850 |
| Practice Fax Number | 3096815658 |
| Mailing Telephone | 3096815850 |
| Mailing Fax Number | 3096815658 |
| Enumeration Date | 2013-10-28 |
| Last Update Date | 2013-10-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 180008837 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962727362 | Melissa Shane | Social Worker | 3606 Front St, San Diego, CA 92103-4005 | 2010-03-29 |
| Street Address |
3020 W. WILLOW KNOLLS DRIVE |
| City | PEORIA |
| State | IL |
| Zip Code | 61614-1002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548818511 | Christine Svoboda | Social Worker | 6919 N Knoxville Ave Ste 100 and 202, Peoria, IL 61614 | 2019-09-03 |
| 1639649007 | Kathy Karouzos Counseling, LLC | Clinic/Center | 330 W. Ivy Ln., Peoria, IL 61614 | 2018-11-28 |
| 1205312790 | Kathleen Marie Hendricks | Nurse Practitioner | 2809 W Willow Knolls Dr, Peoria, IL 61614 | 2018-07-17 |
| 1629563937 | Mary Elizabeth Cunningham | Counselor | 6219 N. Eldorado Dr., Peoria, IL 61614 | 2018-06-28 |
| 1861937955 | Angela Gilles | Social Worker | 6919 N Knoxville Ave Ste 100, Peoria, IL 61614 | 2016-12-27 |
| 1467994897 | Melissa Saxsma | Specialist | 5009 N Executive Dr, Peoria, IL 61614 | 2016-11-16 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1215313143 | Melissa Lynn Phelan | Nurse Practitioner | 122 E Morningside Dr, Peoria, IL 61614 | 2015-08-03 |
| 1811380165 | All Ways Caring Services, Inc. | In Home Supportive Care | 6919 N Knoxville Ave, Suite 102, Peoria, IL 61614 | 2015-03-11 |
| 1568875920 | Schuler & Arkwell Orthodontic Partnership | Dentist | 2425 Cornerstone Ct. Ste. A, Peoria, IL 61614 | 2014-06-03 |
| Find all providers in zip 61614 | ||||
| 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 |
|---|---|---|---|---|
| 1346863628 | Az Synergy Counseling, LLC | Counselor | 20835 N 98th Ave, Peoria, AZ 85382-5100 | 2020-05-21 |
| 1689201584 | Denise Zadwarny | Counselor | 8538 W Lawrence Ln, Peoria, AZ 85345-2537 | 2020-03-23 |
| 1073066155 | Caroline Vanaman | Counselor | 221 Ne Glen Oak Ave # 7w, Peoria, IL 61636-0001 | 2016-07-26 |
| 1952756199 | Bethany Rosenfeld | Counselor | 13460 N 94th Dr Ste K3, Peoria, AZ 85381-4249 | 2016-04-25 |
| 1639597172 | Jael K. Mahasi | Counselor | 1800 Ne Perry Avenue, Peoria, IL 61603 | 2014-04-02 |
| 1538400197 | Lindsy Redman | Counselor | 15396 N 83rd Ave Ste G103, Peoria, AZ 85381-5629 | 2013-03-07 |
| 1225398415 | Curt Meiss | Counselor | 914 W Glen Ave Ste 3, Peoria, IL 61614-4886 | 2012-05-21 |
| 1912204066 | Susan J Luiten | Counselor | 7031 N Patton Ln, Peoria, IL 61614-1918 | 2011-02-24 |
| 1104141688 | Kelly L Lenz | Counselor | 2603 S High Meadow Dr, Peoria, IL 61607-1415 | 2010-03-29 |
| 1326273608 | Rehabilitation Specialists Group, Inc. | Counselor | 7992 W Thunderbird Rd Ste 111c, Peoria, AZ 85381-4905 | 2009-05-15 |
| Find all providers in PEORIA | ||||
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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.