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Individual
MS. MARIE ANN SHADE
Active
Individual
MS. MARIE ANN SHADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCPC44
ID
101YM0800X
Mental Health Counselor
LCPC44
ID
101YP2500X
Professional Counselor
LCPC44
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010016630
REGENCE BLUE SHIELD
ID
01
—
Q1687
BLUE CROSS
ID
Enumeration date
11/06/2006
Last updated
09/11/2025
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