Individual
SHANNON NICOLE LIND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
389 SW SCALEHOUSE CT, BEND, OR 97702-3241
(541) 306-4446
Mailing address
63224 LANCASTER ST, BEND, OR 97701-7149
(458) 256-1611
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
T-25-6087
OR
175T00000X
Peer Specialist
Primary
24-CRM-3373
OR
Other
Enumeration date
06/25/2024
Last updated
11/11/2025
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